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NPI Code Detail

MEDICARE: JOHN NICHOLS ELGIN M.D.

MEDICARE: JOHN NICHOLS ELGIN 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician18422AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
251076882OTHERALBLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number : 1306866199
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN NICHOLS ELGIN M.D.
Provider Business Mailing Address
First Line : 987 SMITH MOUNTAIN DR
Second Line :
City : JACKSONS GAP
State : AL
Zip : 36861-2540
Country : US
Telephone Number : 256-329-7295
Fax Number :
Provider Business Practice Location Address
First Line : 3316 HIGHWAY 280
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-3369
Country : US
Telephone Number : 256-329-7295
Fax Number : 256-329-7186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/09/2007

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