Provider Demographics
NPI:1760420640
Name:ELKINS, WILLIAM E JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:ELKINS
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26732
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2018
Mailing Address - Country:US
Mailing Address - Phone:270-206-9904
Mailing Address - Fax:220-206-9905
Practice Address - Street 1:116 BIBLE XING
Practice Address - Street 2:
Practice Address - City:DECHERD
Practice Address - State:TN
Practice Address - Zip Code:37324-3886
Practice Address - Country:US
Practice Address - Phone:931-968-1236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000001152363A00000X
KYPA829363A00000X
NDPAC0546363A00000X
FLPA9111356363A00000X
GA8818363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95004024Medicaid
KYP00203496OtherRAILROAD MEDICARE
KY95004024Medicaid
KY0647624Medicare ID - Type Unspecified