Individual
DR. JEFFREY MARK ELROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 E CHESTNUT ST STE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(602) 629-3132
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 969-6552
(502) 969-3799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42545
KY
207R00000X
Internal Medicine Physician
R1105
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000620784
ANTHEM - NIS
KY
01
—
000026447T
HUMANA - NIS
KY
01
—
00533139
MEDICARE - NIS
KY
01
—
105793
SIHO - NIS
KY
05
—
200967660
—
IN
01
—
3721116000
PASSPORT ADVTG - NIS
KY
01
—
50024311
PASSPORT - NIS
KY
01
—
6615945
CIGNA - NIS
KY
01
—
7100073850
MEDICAID KY (NIS)
KY
01
—
P00745275
RAILROAD MCR KY - NIS
KY
Enumeration date
02/20/2007
Last updated
01/12/2021
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