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General NPI Number Information
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NPI Number | 1386614345
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Entity Type | Individual
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Provider Name | ELPIDIA H BALBASTRO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 1200 HOSPITAL DR STE 2
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City | OPELOUSAS
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State | LA
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Zip | 70570-6552
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Country | US
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Telephone | 337-942-7898
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Fax | 337-942-7808
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 337-942-7898
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Fax | 225-765-9196
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | J7417
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 40557
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 036085269
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD0000041542
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 036085269
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 309969
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License Number State | LA
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