MEDICARE: DEANNA S ELSEA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD0000031550	TN
2	207R00000X	Internal Medicine Physician	303786	LA

General Provider Information

NPI Number	:	1619966900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA S ELSEA MD

Provider Business Mailing Address
First Line	:	1514 JEFFERSON HWY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-2429
Country	:	US
Telephone Number	:	504-842-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	13100 RIVER RD STE 120
Second Line	:
City	:	DESTREHAN
State	:	LA
Zip	:	70047-5216
Country	:	US
Telephone Number	:	985-764-7669
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	11/15/2017

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Directions to “ DEANNA S ELSEA MD” Practice Location

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