Individual
CLINT EVERETT ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121
(504) 842-4000
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
36697
IA
207L00000X
Anesthesiology Physician
Primary
MD.200494
LA
207L00000X
Anesthesiology Physician
MD200494
LA
207L00000X
Anesthesiology Physician
ME98633
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05353549
—
MS
05
—
0727586
—
IA
05
—
1049930
—
LA
01
—
24014
WELLMARK BCBS
IA
05
—
278323100
—
FL
Enumeration date
05/10/2006
Last updated
02/18/2010
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