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Individual

DR. DOUGLAS E. ELLIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 S UNIVERSITY AVE, SUITE 600, LITTLE ROCK, AR 72205-5302
(501) 664-3914
(501) 664-5246
Mailing address
500 S UNIVERSITY AVE, SUITE 101, LITTLE ROCK, AR 72205-5302
(501) 664-3914
(501) 664-5246

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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