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Contact Information

JENNIFER ELAM, OD
3560 PINE GROVE AVE
STE 366
PORT HURON, MI48060-1994
 Phone: 502-759-1123
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Corneal and Contact Management

152WC0802X 41 Optometry
 

Low Vision Rehabilitation

152WL0500X 41 Optometry
Indicates primary specialty

NPI Profile & details for JENNIFER ELAM · (Female)

NPI # 1356443261
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 09/01/2006
Last updated 06/21/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 1607DT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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