Individual
DR. JIBRAN ELIAS ATWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 YOUNGSVILLE HWY, SUITE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
(337) 330-0059
Mailing address
2308 E MAIN ST, SUITE G, NEW IBERIA, LA 70560-4041
(337) 367-2001
(337) 365-3050
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
10447R
LA
208000000X
Pediatrics Physician
10447R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1988791
—
LA
Enumeration date
08/03/2005
Last updated
11/05/2021
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