Provider Demographics
NPI:1366788416
Name:ELKINS, JOSHUA J
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:J
Last Name:ELKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-3629
Mailing Address - Country:US
Mailing Address - Phone:307-677-4823
Mailing Address - Fax:
Practice Address - Street 1:133 FRONT ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-3629
Practice Address - Country:US
Practice Address - Phone:307-677-4823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies