Individual
MR. THOMAS DAVID ELKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5888
(601) 984-5842
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5888
(601) 984-5842
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
37-645
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121308
—
MS
01
—
680012381
RAILROAD MEDICARE
MS
Enumeration date
06/13/2006
Last updated
07/05/2012
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