Organization
MARK R ELKINS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R ELKINS (PRESIDENT)
(801) 253-6886
Entity
Organization
Contact information
Practice address
4019 W 12600 S, SUITE 120, RIVERTON, UT 84096-7302
(801) 253-6886
(801) 253-6888
Mailing address
4019 W 12600 S, SUITE 120, RIVERTON, UT 84096-7302
(801) 253-6886
(801) 253-6888
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
13128
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5346948-0501
PROFESSIONAL LICENSE
UT
01
—
5346948-8907
CONTROLLED SUBSTANCE
UT
Enumeration date
08/02/2005
Last updated
08/17/2010
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