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Individual
DR. DOUGLAS E. ELLIOTT
Active
Individual
DR. DOUGLAS E. ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
E-3647
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03050014702
QUALCHOICE PROVIDER NUM.
—
05
—
149708001
—
AR
05
—
200010760A
—
OK
Enumeration date
06/19/2006
Last updated
12/16/2011
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