Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 00024049 | AL |
Y | 207X00000X | Orthopaedic Surgeon | 24049 | AL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 00024049 | AL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 24049 | AL |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 00024049 | AL |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 24049 | AL |
NPI | 1366515033 |
---|---|
Provider Name | Dr. Mark Alan Elkus |
First Address | Birmingham, AL 35213 |
Second Address | Birmingham, AL 35213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51553670 | BLUE CROSS- BLUE SHIELD (01) | AL |
51553670 | BLUE CROSS-BLUE SHIELD (01) | |
EL009926035 | (05) | AL |
H84359 | (02) | AL |