Philip B Elledge, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

5313C Issued in AL

Practice address

2314 Pansy St SW
Huntsville, AL 35801-3803

Phone

(256) 534-5028

Fax

(256) 534-5073

NPI assigned

Apr 18, 2006

Last updated

Aug 15, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Huntsville Oral and Maxillofacial Surgery Associates, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntsville, AL
  • NPI 1386740140
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1437114246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 PANSY ST SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013803",
            "telephone_number": "256-534-5028",
            "fax_number": "256-534-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 PANSY ST SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013803",
            "telephone_number": "256-534-5028",
            "fax_number": "256-534-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "PHILIP",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "5313C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite All-Care Services LLC
• Elite Eye Care of Huntsville
• Ashley Elaine Fountain Elkins, CAA
• Tiffani Elkourie, CRNP
• Leslie K Elledge, CRNA
• Elliot L Marcus MD PC
• Jane-Anne Elliott, DNP, FNP-C
• Lateisha Elliott, DBH, MS, LPC, CRC
• Leigh Ellen Elliott, PHARM D
• Ronnie Elliott

• Oral & Maxillofacial Surgery (D.M.D.) in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.