Individual
DR. JEFFREY M ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 MELBA DR, DOTHAN, AL 36301-3017
(334) 794-6611
(334) 794-6614
Mailing address
1901 MELBA DR, DOTHAN, AL 36301-3017
(334) 794-6611
(334) 794-6614
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00025008
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000021979
—
AL
01
—
051521979
BLUE CROSS & BLUE SHIELD
AL
Enumeration date
03/18/2006
Last updated
11/20/2007
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