NPI 1194718379

Jimmy H Elam, OD

Practitioner Optometrist Poplar Bluff, MO

Practice location

Address: 2511 N Westwood Blvd, Poplar Bluff, MO 63901-2338
Phone: (573) 686-5866
Fax: (618) 997-6250
Mailing address: PO Box 1178, Marion, IL 62959-7678

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2189 (MO)

Other Optometrist providers in Missouri →

Registry record

NPI: 1194718379
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Aug 2005
Record last updated: 13 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.