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General NPI Number Information
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NPI Number | 1366441016
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Entity Type | Individual
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Provider Name | JAMES P ELDER MD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 06/04/2012
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Provider Practice Location Address
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Address Line | SOUTH JERSEY RADIOLOGY ASSOCIATES, PA 100 CARNIE BLVD. SUITE B-5
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City | VOORHEES
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State | NJ
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Zip | 08043
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Country | US
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Telephone | 856-751-0123
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Fax | 856-751-0535
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Provider Business Mailing Address
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Address Line | PO BOX 1710 SOUTH JERSEY RADIOLOGY ASSOCIATES PA
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City | VOORHEES
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State | NJ
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Zip | 08043-7710
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Country | US
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Telephone | 856-770-0504
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Fax | 856-770-0395
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA05615700
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License Number State | NJ
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