Provider Demographics
NPI:1134867468
Name:ELAM, ROBERT CHAFFEE
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHAFFEE
Last Name:ELAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SILVER DOLLAR ST
Mailing Address - Street 2:
Mailing Address - City:LASCASSAS
Mailing Address - State:TN
Mailing Address - Zip Code:37085-4651
Mailing Address - Country:US
Mailing Address - Phone:901-800-7464
Mailing Address - Fax:
Practice Address - Street 1:1406 WINTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2530
Practice Address - Country:US
Practice Address - Phone:615-444-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant