Provider Demographics
NPI:1699220988
Name:ADDERLEY, ELAINA (MD)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:
Last Name:ADDERLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 PINE STREET
Mailing Address - Street 2:ENDOCRINOLOGY
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 PINE STREET, SUITE 204
Practice Address - Street 2:THE JACKSON CLINIC
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106
Practice Address - Country:US
Practice Address - Phone:334-293-8877
Practice Address - Fax:334-293-6803
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42540207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism