Provider Demographics
NPI:1265621130
Name:EL KHOURY ANTOUN, GEORGES ELIAS (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGES
Middle Name:ELIAS
Last Name:EL KHOURY ANTOUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3661
Mailing Address - Country:US
Mailing Address - Phone:985-871-4140
Mailing Address - Fax:985-898-4150
Practice Address - Street 1:1006 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3661
Practice Address - Country:US
Practice Address - Phone:985-871-4140
Practice Address - Fax:985-898-4150
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24523207RC0000X
LAMD.206769207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2366416Medicaid