Provider Demographics
NPI:1912613506
Name:ELIZABETH ELKINSON M.D. PLLC
Entity Type:Organization
Organization Name:ELIZABETH ELKINSON M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:ELKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-537-2514
Mailing Address - Street 1:520 SAYRE AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2316
Mailing Address - Country:US
Mailing Address - Phone:859-537-2514
Mailing Address - Fax:859-721-1202
Practice Address - Street 1:3217 SUMMIT PLACE
Practice Address - Street 2:SUITE 150
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2363
Practice Address - Country:US
Practice Address - Phone:859-475-5050
Practice Address - Fax:859-721-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100056670Medicaid