| Dr Larry Nelson Elam, MD | |
|
10055 Ford Ave, Ste 4a, Richmond Hill, GA 31324-3972 | |
| (912) 756-3075 | |
| (912) 756-5291 |
| Full Name | Dr Larry Nelson Elam |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 10055 Ford Ave, Richmond Hill, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306844170 | NPI | - | NPPES |
| 888120761A | Medicaid | GA | |
| G53491 | Medicaid | SC | |
| 206521 | Other | GA | BCBS RICHMOND HILL |
| 260521 | Other | GA | BCBS SAVANNAH |
| 888120761B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 053491 (Georgia) | Primary |
| Entity Name | Southcoast Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467451922 PECOS PAC ID: 9032013271 Enrollment ID: O20040109000192 |
| Entity Name | Privia Medical Group Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013313857 PECOS PAC ID: 4284951542 Enrollment ID: O20150325000983 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Larry Nelson Elam, MD 10055 Ford Ave, Ste 4a, Richmond Hill, GA 31324-3972 Ph: (912) 756-3075 | Dr Larry Nelson Elam, MD 10055 Ford Ave, Ste 4a, Richmond Hill, GA 31324-3972 Ph: (912) 756-3075 |
Jenna Lee Sirmans, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 89 Interchange Dr, Richmond Hill, GA 31324 Phone: 912-527-5352 Fax: 912-756-5291 | |
Dr. Rose White Ruffo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 89 Interchange Dr, Richmond Hill, GA 31324 Phone: 912-527-5352 Fax: 912-756-5291 | |
Leigh Sotos Thompson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 10055 Ford Ave Ste 4a, Richmond Hill, GA 31324 Phone: 912-303-3500 Fax: 912-303-3506 | |
Alyssa Bina Buono, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 10055 Ford Ave Ste 4a, Richmond Hill, GA 31324 Phone: 912-527-5352 | |
Dr. Keith Matthew Seibert, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 60 Exchange St Ste B7, Richmond Hill, GA 31324 Phone: 912-756-2273 | |
Dr. William Edwin Webb, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 10055 Ford Ave, Suite 4a, Richmond Hill, GA 31324 Phone: 912-756-3075 Fax: 912-756-5291 |