Individual
LY-ELAINE PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 KINGS HWY, INTERNAL MEDICINE, SHREVEPORT, LA 71103-4228
(318) 813-2528
(318) 813-2525
Mailing address
1501 KINGS HWY, INTERNAL MEDICINE, SHREVEPORT, LA 71103-4228
(318) 813-2528
(318) 813-2525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
312266
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2016
Last updated
12/10/2021
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