Individual
DAVID ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 360-0199
Mailing address
PO BOX 561, ELIZABETHTOWN, KY 42702-0561
(270) 360-0199
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25297
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220029847
RR MEDICARE
—
Enumeration date
09/28/2006
Last updated
09/01/2010
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