| Elc Medicine Group Llc | |
|
102 Office Park Dr Minden LA 71055-3086 | |
| (318) 377-2885 | |
| (318) 377-0096 |
| Full Name | Elc Medicine Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 102 Office Park Dr, Minden, Louisiana |
| Authorized Official Name and Position | Michael S Chanler (M.D./OWNER) |
| Authorized Official Contact | 3183772885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elc Medicine Group Llc 102 Office Park Dr Minden LA 71055-3086 Ph: (318) 377-2885 | Elc Medicine Group Llc 102 Office Park Dr Minden LA 71055-3086 Ph: (318) 377-2885 |
| NPI Number | 1407236714 |
|---|---|
| Provider Enumeration Date | 06/02/2015 |
| Last Update Date | 12/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407236714 | NPI | - | NPPES |
| 1441678 | Medicaid | LA | |
| 1571181 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD.024145 (Louisiana) | Primary |
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