Provider Demographics
NPI:1619152840
Name:ELKIN, MARK F (PT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:F
Last Name:ELKIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 KENNECOTT WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1174
Mailing Address - Country:US
Mailing Address - Phone:859-361-3727
Mailing Address - Fax:
Practice Address - Street 1:11880 MOSTELLER RD
Practice Address - Street 2:
Practice Address - City:SHARONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45241-1551
Practice Address - Country:US
Practice Address - Phone:513-771-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT0017592251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports