Elliott, Mark William

Elliott, Mark William is an individual health care provider with primary practice located at 3205 S Russell St , Missoula MT 59801-8536. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Elliott, Mark William can be contacted via phone (406) 721-4906.

Contact Information

Primary practice address
3205 S Russell St Missoula MT 59801-8536
Phone: (406) 721-4906
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 7226 Montana
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 7226 Montana

Profile Details

NPI number 1053349415
LBN Legal business name Elliott, Mark William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053349415 NPPES
Montana MEDICAID 0103389

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