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General NPI Number Information
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NPI Number | 1235748146
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Entity Type | Organization
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Legal Business Name | TRIGG COUNTY ORTHOPEDIC FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 1396 CANTON RD
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City | CADIZ
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State | KY
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Zip | 42211-6652
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Country | US
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Telephone | 270-206-9904
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Fax | 220-206-9905
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Provider Business Mailing Address
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Address Line | 1396 CANTON RD
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City | CADIZ
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State | KY
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Zip | 42211-6652
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Country | US
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Telephone | 270-206-9904
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Fax | 220-206-9905
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM E ELKINS JR.
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Credential | PA
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Telephone | 270-206-9904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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