Individual
MR. JOHN DANIEL ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1144 N ROAD ST STE 200, ELIZABETH CITY, NC 27909-3473
(252) 384-2360
(252) 384-2359
Mailing address
1144 N ROAD ST STE 200, ELIZABETH CITY, NC 27909-3473
(252) 384-2360
(252) 384-2359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2012-0192
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2012-01920
NC
Other
Enumeration date
10/28/2005
Last updated
04/23/2021
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