Elliott, John Quincy
Elliott, John Quincy is an sole proprietor health care provider with primary practice located at 2480 Three Rivers Blvd , Poplar Bluff MO 63901-2318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Elliott, John Quincy can be contacted via phone (573) 785-4600.Contact Information
Primary practice address
2480 Three Rivers Blvd
Poplar Bluff MO 63901-2318
Phone: (573) 785-4600
Fax: (573) 785-4611
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 02002722A | Indiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2005039927 | Missouri |
Profile Details
| NPI number | 1922090125 |
|---|---|
| LBN Legal business name | Elliott, John Quincy |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2005 |
| Last updated | May 20th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922090125 | NPPES |
| Indiana | MEDICAID | 200111230A |
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