Organization
DEB ELLIOTT-PEARSON M.D., P.C.
Active
Other names
Bank Street Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH LOIS ELLIOTT-PEARSON M.D. (CEO)
(208) 752-3016
Entity
Organization
Contact information
Practice address
516 BANK ST, WALLACE, ID 83873-2225
(208) 752-3016
(208) 753-1001
Mailing address
516 BANK ST, WALLACE, ID 83873-2225
(208) 752-3016
(208) 753-1001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7469
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805230000
—
ID
Enumeration date
04/23/2008
Last updated
04/29/2008
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