Individual
JOEL GLEN ELDRIDGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
233 TAYLOR AVE, WINNSBORO, LA 71295-2431
(318) 435-8363
(318) 435-0406
Mailing address
425 HIGHWAY 577, WINNSBORO, LA 71295-5367
(318) 722-3759
(318) 435-0406
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08682R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1918296
—
LA
Enumeration date
05/21/2006
Last updated
07/08/2007
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