Individual
DR. JERRY J. ELLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 N WASHINGTON ST, LIVINGSTON, AL 35470-5410
(205) 652-9575
(205) 652-7979
Mailing address
PO BOX 5166, MERIDIAN, MS 39302-5166
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
00008273
AL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
00008273
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51020984
BLUE CROSS OF AL
—
Enumeration date
11/20/2005
Last updated
09/11/2025
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