Individual
DR. PATRICK ROAN ELLENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
726 N ACADIA RD, SUITE 1000, THIBODAUX, LA 70301-5009
(985) 625-2200
(985) 625-2206
Mailing address
PO BOX 28, THIBODAUX, LA 70302-0028
(985) 492-1200
(985) 492-1212
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
026384
LA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
026384
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1066044
—
LA
Enumeration date
02/26/2008
Last updated
05/11/2017
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