Individual
DR. EDWARD F. ELLIOTT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 BELMONT AVE, BRATTLEBORO, VT 05301-6613
(802) 257-8820
(802) 257-8849
Mailing address
88 HIGH ST, BRATTLEBORO, VT 05301-6074
(802) 257-7513
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01029450
IN
2085R0202X
Diagnostic Radiology Physician
Primary
0420008401
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01029450
—
IN
Enumeration date
06/21/2006
Last updated
07/08/2007
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