Provider Demographics
NPI:1174538821
Name:ELKINS, CAROL G (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:G
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 1:820 TURNPIKE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1233
Mailing Address - Country:US
Mailing Address - Phone:814-765-5712
Mailing Address - Fax:814-765-3141
Practice Address - Street 1:820 TURNPIKE AVE
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-1233
Practice Address - Country:US
Practice Address - Phone:814-765-5712
Practice Address - Fax:814-765-3141
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-036923-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000410365OtherBLUE CROSS
PA001133093Medicaid
PAE81501Medicare UPIN
PA410365Medicare ID - Type Unspecified