Individual
MARK WAYNE ELKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 A ST SW, MIAMI, OK 74354-6806
(918) 542-1836
Mailing address
130 A ST SW, MIAMI, OK 74354-6806
(918) 542-1836
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20887
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100207350B
—
OK
Enumeration date
12/13/2006
Last updated
07/12/2010
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