Healthcare Provider Details

I. General information

NPI: 1801466172
Provider Name (Legal Business Name): ELIAS EUGENE VOLK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 INTEGRITY DR BLDG S771
MILLINGTON TN
38054-5028
US

IV. Provider business mailing address

400 RUSSELL AVE BLDG 41
BELLE CHASSE LA
70037-1006
US

V. Phone/Fax

Practice location:
  • Phone: 301-874-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101276114
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: