Organization
REGINA J ELKINS OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA J ELKINS O.D. (OWNER/OPTOMETRIST)
(931) 729-2190
Entity
Organization
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
TN1419
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G702347
MEDICARE PART B
TN
Enumeration date
09/17/2012
Last updated
08/11/2016
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