MEDICARE: JAMES MICHAEL ELMORE 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	2088P0231X	Pediatric Urology Physician	055002	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

General Provider Information

NPI Number	:	1336174085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MICHAEL ELMORE M.D.

Provider Business Mailing Address
First Line	:	1930 BRANNAN RD
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-4310
Country	:	US
Telephone Number	:	678-284-4040
Fax Number	:	678-284-4076

Provider Business Practice Location Address
First Line	:	5445 MERIDIAN MARKS RD
Second Line	:	SUITE 420
City	:	ATLANTA
State	:	GA
Zip	:	30342-4763
Country	:	US
Telephone Number	:	404-252-5206
Fax Number	:	404-252-1268

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	06/03/2026

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