Individual
MR. ROBERT BRUCE ELLIOTT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W VOTAW STREET, PORTLAND, IN 47371-1322
(260) 726-1934
(260) 726-1911
Mailing address
500 W VOTAW STREET, PORTLAND, IN 47371-1322
(260) 726-7131
(260) 726-1975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027759A
IN
208000000X
Pediatrics Physician
01027759A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100468680
—
IN
Enumeration date
06/05/2006
Last updated
09/18/2015
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