Provider Demographics
NPI:1801853809
Name:MCELROY, ROBIN AARON (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:AARON
Last Name:MCELROY
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 1:101 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-2915
Mailing Address - Country:US
Mailing Address - Phone:870-364-2990
Mailing Address - Fax:870-364-3104
Practice Address - Street 1:101 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-2915
Practice Address - Country:US
Practice Address - Phone:870-364-2990
Practice Address - Fax:870-364-3104
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 2302225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X735OtherBLUE CROSS BLUE SHIELD
AR154414721Medicaid
AR5X735Medicare ID - Type Unspecified