MEDICARE: ELIZABETH LE

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	213E00000X	Podiatrist	PD173R	LA

General Provider Information

NPI Number	:	1730359852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH LE

Provider Business Mailing Address
First Line	:	1524 S RANGE AVE
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-5218
Country	:	US
Telephone Number	:	225-667-6497
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 S RANGE AVE
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-5218
Country	:	US
Telephone Number	:	225-667-6497
Fax Number	:

Authorized Official
Title or Position	:	PODIATRIST
Name	:	ELIZABETH LE
Credential	:	DPM
Telephone Number	:	225-667-6497

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	03/04/2008

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