Provider Demographics
NPI:1518073576
Name:EHLENBERGER, ERIC R
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:EHLENBERGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-4730
Mailing Address - Country:US
Mailing Address - Phone:504-472-6130
Mailing Address - Fax:504-472-6128
Practice Address - Street 1:2401 VETERANS MEMORIAL BLVD STE 16
Practice Address - Street 2:ACCURATE CLINIC
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-4779
Practice Address - Country:US
Practice Address - Phone:504-472-6130
Practice Address - Fax:504-472-6128
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014927207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine