Provider Demographics
NPI:1669445847
Name:ELKINS, ANTHONY (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:ELKINS
Suffix:
Gender:M
Credentials:DO
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 896199
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0447
Mailing Address - Country:US
Mailing Address - Phone:833-936-1364
Mailing Address - Fax:
Practice Address - Street 1:114 GATEWAY BLVD STE B
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5598
Practice Address - Country:US
Practice Address - Phone:980-435-0406
Practice Address - Fax:980-435-0409
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913202Medicaid
NC2401261CMedicare PIN
NC8913202Medicaid