Provider Demographics
NPI:1144428400
Name:MCLEMORE, ELIZABETH QUILLIN (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:QUILLIN
Last Name:MCLEMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8124
Mailing Address - Country:US
Mailing Address - Phone:318-487-1289
Mailing Address - Fax:
Practice Address - Street 1:501 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-487-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205641207V00000X
VA0116019662390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program