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General NPI Number Information
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NPI Number | 1396862645
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Entity Type | Individual
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Provider Name | EDWARD BRYAN ELKINS DDS
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 109 FRONT ST S
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City | COWAN
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State | TN
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Zip | 37318-3311
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Country | US
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Telephone | 931-967-7092
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Fax | 931-967-7303
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Provider Business Mailing Address
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Address Line | PO BOX 516
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City | COWAN
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State | TN
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Zip | 37318-0516
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Country | US
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Telephone | 931-967-7092
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Fax | 931-967-7303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS006868
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License Number State | TN
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