Provider Demographics
NPI:1568468270
Name:ELDER, JAMES EARNEST (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EARNEST
Last Name:ELDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3560 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5722
Mailing Address - Country:US
Mailing Address - Phone:205-949-2806
Mailing Address - Fax:205-949-2875
Practice Address - Street 1:3550 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5710
Practice Address - Country:US
Practice Address - Phone:205-949-2806
Practice Address - Fax:205-949-2875
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11242207ZD0900X
FLME93129207ZD0900X
GA056703207ZD0900X
NC2005-01455207ZD0900X
TN41316207ZD0900X
SC31214207ZD0900X
VA0101244538207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009945475Medicaid
E357648Medicare UPIN
AL009945475Medicaid