Provider Demographics
NPI:1104857010
Name:ELKINS, KATHRYN C (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:C
Last Name:ELKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59325 RIVER WEST DRIVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764
Mailing Address - Country:US
Mailing Address - Phone:225-687-3055
Mailing Address - Fax:225-687-6686
Practice Address - Street 1:59325 RIVER WEST DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764
Practice Address - Country:US
Practice Address - Phone:225-687-3055
Practice Address - Fax:225-687-6686
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018197174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1378712Medicaid