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Organization

ELLENDER FAMILY MEDICINE, APMC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEE DARRELL ELLENDER M.D. (PRESIDENT)
(337) 594-8958
Entity
Organization

Contact information

Practice address
2967 S UNION ST, OPELOUSAS, LA 70570-5740
(337) 594-8958
(337) 594-8987
Mailing address
2967 S UNION ST, OPELOUSAS, LA 70570-5740
(337) 594-8958
(337) 594-8987

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024917
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1422991
LA
Enumeration date
03/19/2007
Last updated
03/13/2017
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