Individual
DR. JOHN GREGORY ELDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
630 BURNETT DR, MOUNTAIN HOME, AR 72653-2941
(870) 425-6971
(870) 508-8900
Mailing address
630 BURNETT DR, MOUNTAIN HOME, AR 72653-2941
(870) 425-6971
(870) 508-8900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C7687
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080035552
RAILROAD MEDICARE
AR
05
—
121500001
—
AR
Enumeration date
06/30/2005
Last updated
04/27/2016
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