Individual
CHARLES ELIOT DEGRAVELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5820
(225) 761-5369
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
301841
LA
2084P0800X
Psychiatry Physician
41515
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05372271
—
MS
05
—
2429507
—
LA
Enumeration date
09/25/2006
Last updated
12/13/2016
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