Individual
CLARK A. ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1104 CASS ST, TRAVERSE CITY, MI 49684-3236
(231) 941-1155
(231) 259-1005
Mailing address
1104 CASS ST, TRAVERSE CITY, MI 49684-3236
(231) 941-1155
(231) 259-1005
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
12266
ND
207Y00000X
Otolaryngology Physician
41717
KY
207YP0228X
Pediatric Otolaryngology Physician
41717
KY
Other
Enumeration date
05/28/2006
Last updated
01/16/2025
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