Individual
REGINA J ELKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
205 1/2 E PUBLIC SQ, CENTERVILLE, TN 37033-1601
(931) 729-2190
(931) 729-2805
Mailing address
205 1/2 E PUBLIC SQ, CENTERVILLE, TN 37033-1601
(931) 729-2190
(931) 729-2805
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000001419
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I181431
MEDICARE PART B
TN
01
—
103I413138
MEDICARE PART B
TN
05
—
3598650
—
TN
01
—
3598653
MEDICARE PTAN
TN
Enumeration date
09/17/2006
Last updated
09/24/2015
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