Individual
THOMAS R ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1980 W HOSPITAL DR STE 300, TUCSON, AZ 85704-7805
(520) 742-9062
(520) 797-8627
Mailing address
1980 W HOSPITAL DR STE 300, TUCSON, AZ 85704-7805
(520) 742-9062
(520) 797-8627
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11650
AZ
2086S0129X
Vascular Surgery Physician
Primary
11650
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234823
—
AZ
01
—
P00998677
MEDICARE RAIL ROAD
AZ
Enumeration date
01/11/2007
Last updated
09/26/2012
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