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General NPI Number Information
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NPI Number | 1043447196
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Entity Type | Individual
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Provider Name | ERIC PAUL ELIAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 1546 GARY DR
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-3447
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Country | US
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Telephone | 337-442-1770
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Fax | 337-442-1594
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Provider Business Mailing Address
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Address Line | 1546 GARY DR
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-3447
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Country | US
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Telephone | 337-442-1770
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Fax | 337-442-1594
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 203619
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License Number State | LA
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