Provider Demographics
NPI:1457422495
Name:ELKINS, JOAN S (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:S
Last Name:ELKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-283-7000
Mailing Address - Fax:207-282-9128
Practice Address - Street 1:4 SHAPE DR
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6760
Practice Address - Country:US
Practice Address - Phone:207-467-8988
Practice Address - Fax:207-467-8969
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45804207P00000X
MEMD19891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1457422495Medicaid