Provider Demographics
NPI:1316952278
Name:BAILEY & ELIAS OBSTETRICAL CARE, LLC
Entity type:Organization
Organization Name:BAILEY & ELIAS OBSTETRICAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-616-0800
Mailing Address - Street 1:1322 ELTON RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-4138
Mailing Address - Country:US
Mailing Address - Phone:337-616-0800
Mailing Address - Fax:337-824-2575
Practice Address - Street 1:1322 ELTON RD
Practice Address - Street 2:SUITE H
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4138
Practice Address - Country:US
Practice Address - Phone:337-616-0800
Practice Address - Fax:337-824-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016806174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448532Medicaid