Provider Demographics
NPI:1225051659
Name:LINDA C MCELVEEN MD LLC
Entity Type:Organization
Organization Name:LINDA C MCELVEEN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCELVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-781-8565
Mailing Address - Street 1:85 WHISPERWOOD BLVD
Mailing Address - Street 2:STE 2AA
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1136
Mailing Address - Country:US
Mailing Address - Phone:985-781-8565
Mailing Address - Fax:
Practice Address - Street 1:1850 GAUSE BLVD E
Practice Address - Street 2:STE 103
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5442
Practice Address - Country:US
Practice Address - Phone:985-781-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CU65Medicare PIN