Provider Demographics
NPI:1417438631
Name:ELAKIL, AHMAD MOUSTAFA (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:MOUSTAFA
Last Name:ELAKIL
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:DR
Other - First Name:AHMED
Other - Middle Name:MUSTAFA
Other - Last Name:ALAQEEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD,MBA
Mailing Address - Street 1:3704 NORTH BLVD.
Mailing Address - Street 2:STE C
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301
Mailing Address - Country:US
Mailing Address - Phone:318-443-4576
Mailing Address - Fax:318-445-5579
Practice Address - Street 1:1200 CAMELLIA BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6163
Practice Address - Country:US
Practice Address - Phone:337-534-4996
Practice Address - Fax:337-534-4579
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA321532207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty