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Individual

KEITH BRIAN ELBOURNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6550 MAIN ST., SUITE 2000, ZACHARY, LA 70791-4033
(225) 658-1303
(225) 658-1304
Mailing address
2335 CHURCH ST STE E, ZACHARY, LA 70791-2700
(225) 570-2489
(225) 570-2986

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.026232
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053074
LA
Enumeration date
07/16/2006
Last updated
01/23/2020
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