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General NPI Number Information
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NPI Number | 1316146228
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC SPORTS SPECIALISTS OF LOUISIANA LLC
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 726 N ACADIA RD STE 1000
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City | THIBODAUX
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State | LA
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Zip | 70301-5051
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Country | US
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Telephone | 985-625-2200
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Fax | 985-625-2206
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Provider Business Mailing Address
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Address Line | 726 N ACADIA RD STE 1000
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City | THIBODAUX
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State | LA
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Zip | 70301-5051
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Country | US
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Telephone | 985-625-2200
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Fax | 985-625-2206
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. DAVID W ELIAS
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Credential | M.D.
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Telephone | 985-625-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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