MEDICARE: DR. LARRY NELSON ELAM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	053491	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	206521	OTHER	GA	BCBS RICHMOND HILL
4	260521	OTHER	GA	BCBS SAVANNAH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306844170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY NELSON ELAM M.D.

Provider Business Mailing Address
First Line	:	10055 FORD AVE
Second Line	:	STE 4A
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-3972
Country	:	US
Telephone Number	:	912-756-3075
Fax Number	:	912-756-5291

Provider Business Practice Location Address
First Line	:	10055 FORD AVE
Second Line	:	STE 4A
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-3972
Country	:	US
Telephone Number	:	912-756-3075
Fax Number	:	912-756-5291

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	06/25/2008

Similar Medicare Providers

1972501799 — DR. WALLACE EARL HOLLAND JR. M.D.
Practice Location Address:

10055 FORD AVE , SUITE 5A
RICHMOND HILL, GA
31324-3972

Practice Phone: 912-756-2020
Practice Fax: 912-756-3187

1144229824 — MS. VICKI LYNN DRIGGERS N.P.
Practice Location Address:

10055 FORD AVE , SUITE 5A
RICHMOND HILL, GA
31324-3972

Practice Phone: 912-756-2020
Practice Fax: 912-756-3187

1376535260 — MRS. CHRISTINA MICHELLE JOHNSON PA-C
Practice Location Address:

10055 FORD AVE , STE 4A
RICHMOND HILL, GA
31324-3972

Practice Phone: 912-756-3075
Practice Fax: 912-756-5291

1376522722 — DR. JUSTIN WILLIAM BORDLEMAY DMD
Practice Location Address:

10055 FORD AVE STE 3C
RICHMOND HILL, GA
31324-3972

Practice Phone: 912-445-5311
Practice Fax: 912-445-0738

1699797324 — DR. WILLIAM EDWIN WEBB M.D.
Practice Location Address:

10055 FORD AVE , SUITE 4A
RICHMOND HILL, GA
31324-3972

Practice Phone: 912-756-3075
Practice Fax: 912-756-5291

1336285469 — DR. LISA HUTCHERSON KIND D.C
Practice Location Address:

10055 FORD AVE , 3-C
RICHMOND HILL, GA
31324-3972

Practice Phone: 912-459-1200
Practice Fax: 912-459-1201

Directions to “ DR. LARRY NELSON ELAM M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.