Organization
CLYDE E. ELLIOTT, M. D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE EDWIN ELLIOTT M. D. (PRESIDENT)
(318) 388-4863
Entity
Organization
Contact information
Practice address
304 CIRCLE DR, WEST MONROE, LA 71291-5308
(318) 388-4863
(318) 388-1144
Mailing address
304 CIRCLE DR, WEST MONROE, LA 71291-5308
(318) 388-4863
(318) 388-1144
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
10533
LA
Other
Enumeration date
09/08/2010
Last updated
11/01/2011
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