Provider Demographics
NPI:1235748146
Name:TRIGG COUNTY ORTHOPEDIC FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:TRIGG COUNTY ORTHOPEDIC FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA
Authorized Official - Phone:270-206-9904
Mailing Address - Street 1:1396 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-6652
Mailing Address - Country:US
Mailing Address - Phone:270-206-9904
Mailing Address - Fax:220-206-9905
Practice Address - Street 1:1396 CANTON RD
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-6652
Practice Address - Country:US
Practice Address - Phone:270-206-9904
Practice Address - Fax:220-206-9905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty