Provider Demographics
NPI:1780784975
Name:ELKINS, JAMES PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILIP
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 1:201 S 19TH ST
Mailing Address - Street 2:SUITE S
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1119
Mailing Address - Country:US
Mailing Address - Phone:479-636-0300
Mailing Address - Fax:479-636-4576
Practice Address - Street 1:201 S 19TH ST
Practice Address - Street 2:SUITE S
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1119
Practice Address - Country:US
Practice Address - Phone:479-636-0300
Practice Address - Fax:479-636-4576
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4703174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC4703OtherAR LICENSE #
ARB90160Medicare UPIN