Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 11718 | MS |
NPI | 1336176817 |
---|---|
Provider Name | Dr. Stephanie L. Elkins |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 09/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1691321 | (05) | LA |
96397 | (05) | MS |
D80529 | (02) | MS |
P00462196 | RAILROAD MEDICARE PTAN (01) | MS |
RR 820000133 | RAILROAD (01) | MS |