Provider Demographics
NPI:1043447196
Name:ELIAS, ERIC PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:PAUL
Last Name:ELIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1546 GARY DR
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-3447
Mailing Address - Country:US
Mailing Address - Phone:337-442-1770
Mailing Address - Fax:337-442-1594
Practice Address - Street 1:1546 GARY DR
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-3447
Practice Address - Country:US
Practice Address - Phone:337-442-1770
Practice Address - Fax:337-442-1594
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology