Healthcare Provider Details

I. General information

NPI: 1225841091
Provider Name (Legal Business Name): LELAND H ELCHOS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28452 BRADLEY RD STE E
PASS CHRISTIAN MS
39571-0137
US

IV. Provider business mailing address

28452 BRADLEY RD STE E
PASS CHRISTIAN MS
39571-0137
US

V. Phone/Fax

Practice location:
  • Phone: 228-220-1370
  • Fax: 228-206-0981
Mailing address:
  • Phone: 228-220-1370
  • Fax: 228-206-0981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1406
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: