Provider Demographics
NPI:1982678538
Name:ELKINS, GREGORY A (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:A
Last Name:ELKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25523-1138
Mailing Address - Country:US
Mailing Address - Phone:304-824-5806
Mailing Address - Fax:304-824-5885
Practice Address - Street 1:7400 LYNN AVE
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25523-1138
Practice Address - Country:US
Practice Address - Phone:304-824-5806
Practice Address - Fax:304-824-5885
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15896207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0054002000Medicaid
WV000670906OtherMS BCBS
WV0690014OtherSIGNA
WV4275131OtherAETNA
WV0890076470OtherMEDICARE RR
WV000670906OtherMS BCBS
WV0054002000Medicaid
WV0690014OtherSIGNA
WVWV1118B663Medicare Oscar/Certification
WVWV1118GMedicare Oscar/Certification
WVWV1118AMedicare Oscar/Certification
WVWV1118B662Medicare Oscar/Certification
F10500Medicare UPIN
WVWV1118BMedicare Oscar/Certification
WV2016171Medicare PIN
WVWV1118CMedicare Oscar/Certification