Individual
CLYDE DALE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1022 1ST ST N, SUITE 500, ALABASTER, AL 35007-8706
(205) 663-5775
(205) 664-2112
Mailing address
1022 1ST ST N, SUITE 500, ALABASTER, AL 35007-8706
(205) 663-5775
(205) 664-2112
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
6974
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051552706
—
AL
Enumeration date
12/27/2005
Last updated
07/21/2010
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