Elliott, Robert E.
Elliott, Robert E. is an sole proprietor health care provider with primary practice located at 2722 Old Mill Dr , Racine WI 53405-1320. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Elliott, Robert E. can be contacted via phone (262) 632-2020.Contact Information
Primary practice address
2722 Old Mill Dr
Racine WI 53405-1320
Phone: (262) 632-2020
Fax: (262) 632-7085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2658 | Wisconsin |
Profile Details
| NPI number | 1669450151 |
|---|---|
| LBN Legal business name | Elliott, Robert E. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Jul 21st, 2022 - about 2 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 | 1669450151 | NPPES |
| Wisconsin | MEDICAID | 38620900 |
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