Individual
ELISE FONTENOT EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2300 HOSPITAL DR STE 120, BOSSIER CITY, LA 71111-2193
(318) 212-7982
(318) 212-7989
Mailing address
2300 HOSPITAL DR STE 120, BOSSIER CITY, LA 71111-2193
(318) 212-7982
(318) 212-7989
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
312926
LA
Other
Enumeration date
04/07/2016
Last updated
07/06/2021
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