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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306844170 | NPPES |
| Georgia | MEDICAID | 888120761A | |
| Georgia | MEDICAID | G53491 | |
| Georgia | Other | 206521 | |
| Georgia | Other | 260521 | |
| Georgia | MEDICAID | 888120761B |
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