Provider Demographics
NPI:1306859848
Name:ELAHI-NEAL, MERCY ANGELA (OD)
Entity Type:Individual
Prefix:DR
First Name:MERCY
Middle Name:ANGELA
Last Name:ELAHI-NEAL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:ANGELA
Other - Last Name:ELAHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3473 HIGHWAY 15
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-8163
Mailing Address - Country:US
Mailing Address - Phone:318-680-1916
Mailing Address - Fax:318-325-7034
Practice Address - Street 1:303 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8316
Practice Address - Country:US
Practice Address - Phone:318-387-7257
Practice Address - Fax:318-325-7034
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1365-499T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1621498Medicaid
LA5CQ52Medicare ID - Type UnspecifiedGROUP NUMBER
LA1621498Medicaid