Individual
DR. DONALD M ELGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 LONE OAK CIRCLE, FT. GIBSON, OK 74434
(918) 478-2101
(918) 478-6008
Mailing address
PO BOX 1008, TAHLEQUAH, OK 74465-1008
(918) 478-2101
(918) 478-6008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11727
OK
207QA0505X
Adult Medicine Physician
11727
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123270A
—
OK
01
—
107709001
DMERC
OK
01
—
80161083
RR MEDICARE
OK
Enumeration date
08/25/2006
Last updated
05/13/2010
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