Individual
MARK ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
HIGHWAY 20 WEST, PALATKA, FL 32177
(352) 347-7920
Mailing address
200 CORPORATE BLVD, SUITE 200, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA2581
FL
363AM0700X
Medical Physician Assistant
Primary
PA2014-0079
NM
Other
Enumeration date
05/18/2006
Last updated
10/29/2014
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