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General NPI Number Information
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NPI Number | 1487663274
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Entity Type | Organization
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Legal Business Name | SCOTT R. ELKIN, DO, PA
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 1510 W 34TH ST STE 205
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City | AUSTIN
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State | TX
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Zip | 78703-1494
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Country | US
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Telephone | 512-306-0061
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Fax | 512-306-0069
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Provider Business Mailing Address
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Address Line | PO BOX 4595
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City | AUSTIN
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State | TX
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Zip | 78765-4595
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Country | US
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Telephone | 512-306-0061
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Fax | 512-306-0069
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Authorized Official
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Title or Position | CEO / PRESIDENT
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Name | DR. SCOTT R. ELKIN
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Credential | DO
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Telephone | 512-306-0061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G1644
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License Number State | TX
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