Provider Demographics
NPI:1598045775
Name:JUSTIS, ELVIS JEFF JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ELVIS
Middle Name:JEFF
Last Name:JUSTIS
Suffix:JR
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 1:710 LONGMEADOW DRIVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655
Mailing Address - Country:US
Mailing Address - Phone:662-236-2940
Mailing Address - Fax:662-236-2940
Practice Address - Street 1:710 LONGMEADOW DRIVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-236-2940
Practice Address - Fax:662-236-2940
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11939207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA-BJ9023007OtherDEPT. OF JUSTICE