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General NPI Number Information
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NPI Number | 1639226442
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Entity Type | Individual
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Provider Name | ELIZABETH MARIE MCDONOUGH MD
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 7777 HENNESSY BLVD STE 502
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City | BATON ROUGE
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State | LA
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Zip | 70808-4300
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Country | US
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Telephone | 225-765-6834
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Fax |
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Provider Business Mailing Address
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Address Line | 2051 SILVERSIDE DR STE 260
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City | BATON ROUGE
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State | LA
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Zip | 70808-9005
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Country | US
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Telephone | 225-490-6301
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Fax | 225-765-9539
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | E-7508
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | MD.208090
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License Number State | LA
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