Elam, Larry Nelson

Elam, Larry Nelson is an individual health care provider with primary practice located at 10055 Ford Ave Ste 4A, Richmond Hill GA 31324-3972. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Elam, Larry Nelson can be contacted via phone (912) 756-3075.

Contact Information

Primary practice address
10055 Ford Ave Ste 4A Richmond Hill GA 31324-3972
Phone: (912) 756-3075
Fax: (912) 756-5291
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 053491 Georgia

Profile Details

NPI number 1306844170
LBN Legal business name Elam, Larry Nelson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Jun 25th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306844170 NPPES
Georgia MEDICAID 888120761A
Georgia MEDICAID G53491
Georgia Other 206521
Georgia Other 260521
Georgia MEDICAID 888120761B

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