Provider Demographics
NPI:1396130340
Name:ELDER, COURTNEY C (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:C
Last Name:ELDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:C
Other - Last Name:CRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:49 JESSE HILL JR DR SE
Mailing Address - Street 2:480A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3049
Mailing Address - Country:US
Mailing Address - Phone:404-251-8796
Mailing Address - Fax:404-251-8680
Practice Address - Street 1:49 JESSE HILL JR DR SE
Practice Address - Street 2:480A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3049
Practice Address - Country:US
Practice Address - Phone:404-251-8796
Practice Address - Fax:404-251-8680
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X
GA82414207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program