Individual
DR. MARK E. ELKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD PA
Contact information
Practice address
200 GORHAM RD, SUITE 940, SOUTH PORTLAND, ME 04106-2409
(207) 761-9054
(207) 879-9003
Mailing address
200 GORHAM RD, SUITE 940, SOUTH PORTLAND, ME 04106-2409
(207) 761-9054
(207) 879-9003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT758
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120910000
—
ME
Enumeration date
10/03/2006
Last updated
11/09/2012
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