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Active NPI 1144651209 Organization (Entity Type 2)

Mark J Elder Do Pa

Family Medicine • Jay, FL

About Mark J Elder Do Pa NPI 1144651209 Summary

Mark J Elder Do Pa is a verified healthcare organization specializing in Family Medicine operating in Jay, FL. Located at 3887 SCOTTS PLAZA DR, this facility provides patient care and medical services under National Provider Identifier (NPI) 1144651209.

Administrative operations and authorized compliance are overseen by Lori Elder (Practice Manager).

The facility is associated with 2 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

3887 Scotts Plaza Dr

Jay, FL 325654001

Telephone 8509810320
Fax 8509810911

Authorized Official Information

Authorized Contact Name

Lori Elder

Title / Role

Practice Manager

Official Telephone

8509810320

Facility Classifications & Specialties

Family Medicine Primary Taxonomy

NUCC Taxonomy Code: 207Q00000X

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

2 Linked
Dr. Mark Elder , DO NPI 1477559409

Family Medicine

Jay, FL

View Practitioner Profile →
Matthew Brown , PA-C NPI 1912329517

Physician Assistant - Medical

Jay, FL

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active May 04, 2016

NPI status registered as active in NPPES database

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Updated Practice Location May 04, 2016

Registered at 3887 SCOTTS PLAZA DR, JAY, FL 325654001 (Tel: 8509810320)

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Updated Business Mailing Address May 04, 2016

Registered at 3887 SCOTTS PLAZA DR, JAY, FL 325654001 (Tel: 8509810320)

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Organization / Clinic Name Updated May 04, 2016

Operating as MARK J ELDER DO PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 04, 2016

Family Medicine (License #OS8505 in FL)

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Initial NPI Registration & Enumeration November 27, 2013

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1144651209
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: November 27, 2013
Last Update: May 04, 2016

Mailing Address

3887 Scotts Plaza Dr

Jay, FL 325654001

Phone: 8509810320

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.