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Individual

DOUGLAS R ELLIOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
407 S WHITE ST, SUITE 103, MOUNT PLEASANT, IA 52641-2262
(319) 385-6166
(319) 385-6597
Mailing address
407 S WHITE ST, SUITE 103, MOUNT PLEASANT, IA 52641-2262
(319) 385-6166
(319) 385-6597

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23933
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1037697
IA
01
44596
WELLMARK
IA
01
918
MIDLANDS CHOICE
IA
01
P00178712
RAILROAD MEDICARE PIN
IA
Enumeration date
02/09/2007
Last updated
11/14/2007
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