Provider Demographics
NPI:1902916620
Name:HADDAD, ELSA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELSA
Middle Name:M
Last Name:HADDAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:571 SOUTH FLOYD SUITE 300
Mailing Address - Street 2:KOSAIR CHILDREN'S HOSPITAL
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-494-8375
Mailing Address - Fax:
Practice Address - Street 1:2606 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-1642
Practice Address - Country:US
Practice Address - Phone:502-494-8375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035086A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics