Provider Demographics
NPI:1699981639
Name:ELKINS, CAMILLE TALLINI (MD)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:TALLINI
Last Name:ELKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:ELIZABETH
Other - Last Name:TALLINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5052 W 4TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1069
Mailing Address - Country:US
Mailing Address - Phone:601-261-2587
Mailing Address - Fax:601-264-7426
Practice Address - Street 1:2809 DENNY AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5301
Practice Address - Country:US
Practice Address - Phone:614-293-2458
Practice Address - Fax:614-293-7273
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
MS22720207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No174400000XOther Service ProvidersSpecialist