MEDICARE: DR. ROY J ELFRINK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	100371	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356344931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY J ELFRINK M.D.

Provider Business Mailing Address
First Line	:	2305 S HIGHWAY 65 BLDG A
Second Line	:
City	:	MARSHALL
State	:	MO
Zip	:	65340-3702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 S HIGHWAY 65 BLDG A
Second Line	:
City	:	MARSHALL
State	:	MO
Zip	:	65340-3702
Country	:	US
Telephone Number	:	660-886-6692
Fax Number	:	660-831-3355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	03/05/2024

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