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Individual

DR. JACK D ELDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
709 HOLLYBROOK DR, SUITE 3401, LONGVIEW, TX 75605-2411
(903) 753-1778
(903) 753-7202
Mailing address
PO BOX 847176, DALLAS, TX 75284-7176
(903) 237-1800
(903) 237-1810

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
D2419
TX

Other

Enumeration date
03/02/2006
Last updated
09/04/2012
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