# J B ELLIOT MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902856164
- **Authorized official:** JERRY BRUGLER ELLIOT M.D. (PRESIDENT)
- **Authorized official phone:** (989) 427-3511

## Contact information

- **Practice address:** 1380 E MAIN ST, EDMORE, MI 48829-8339
- **Practice address phone:** (989) 427-3511
- **Mailing address:** 1201 SOUTH DR, STE 220, MT PLEASANT, MI 48858-3256
- **Mailing address phone:** (989) 773-3411
- **Mailing address fax:** (989) 775-3187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 4301047281 | MI | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 08/22/2020