Organization
GRACE FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALENCIA CLAYTON ELLIS PA (PHYSICIAN ASSISTANT)
(225) 381-6765
Entity
Organization
Contact information
Practice address
3849 NORTH BLVD, SUITE 100, BATON ROUGE, LA 70806-3854
(225) 381-6765
(225) 381-6767
Mailing address
24438 PLANK RD, SLAUGHTER, LA 70777-9701
(225) 381-6765
(225) 381-6767
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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