Organization
DOUGLAS R ELLIOTT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS R ELLIOTT MD, PC (PRESIDENT)
(319) 385-6166
Entity
Organization
Contact information
Practice address
407 S WHITE ST, SUITE 103, MT PLEASANT, IA 52641-2262
(319) 385-6166
(319) 385-6597
Mailing address
407 S WHITE ST, SUITE 103, MT 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
—
0284927
—
IA
Enumeration date
10/01/2007
Last updated
10/01/2007
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