Individual
DR. MICHAEL ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
(865) 541-2787
Mailing address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12696
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100022685
PHP TENNCARE
TN
05
—
3181469
—
TN
01
—
4087791
BLUE CROSS OF TN
TN
01
—
P00168897
TRAVELERS MEDICARE
TN
Enumeration date
11/07/2005
Last updated
06/17/2010
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