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Individual

JOHN L ELFERVIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342
Mailing address
825 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9411
(901) 685-2200
(901) 820-2342

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
14866
MS
207W00000X
Ophthalmology Physician
MD009929
TN
207W00000X
Ophthalmology Physician
R4424
AR
207WX0107X
Retina Specialist (Ophthalmology) Physician
14866
MS
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
9929
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
R4424
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00115592
MS
05
107447001
AR
01
180024050
PALMETTO RR MEDICARE
TN
05
202004503
MO
05
3190249
TN
01
P00658339
PALMETTO RR MEDICARE
MS
Enumeration date
06/14/2006
Last updated
01/15/2018
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