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NPI Code Detail

MEDICARE: MARK WAYNE ELKINGTON M.D.

MEDICARE: MARK WAYNE ELKINGTON 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
1174400000XSpecialist20887OK

Other Identifiers

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

General Provider Information

NPI Number : 1790846582
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK WAYNE ELKINGTON M.D.
Provider Business Mailing Address
First Line : 130 A ST SW
Second Line :
City : MIAMI
State : OK
Zip : 74354-6806
Country : US
Telephone Number : 918-542-1836
Fax Number :
Provider Business Practice Location Address
First Line : 130 A ST SW
Second Line :
City : MIAMI
State : OK
Zip : 74354-6806
Country : US
Telephone Number : 918-542-1836
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2006
Last Update Date : 07/12/2010

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