Clyde E. Elliott, M. D. a Professional Corporation

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

10533 Issued in LA

Legal business name

CLYDE E. ELLIOTT, M. D. A PROFESSIONAL CORPORATION

Practice address

304 Circle Dr
West Monroe, LA 71291-5308

Phone

(318) 388-4863

Fax

(318) 388-1144

NPI assigned

Sep 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clyde Edwin Elliott, M. D.NPI 1326058918

Title

President

Phone

(318) 388-4863

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clyde E Elliott, MD

  • Family Medicine Physician
  • West Monroe, LA
  • NPI 1326058918
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1265749519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 CIRCLE DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915308",
            "telephone_number": "318-388-4863",
            "fax_number": "318-388-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 CIRCLE DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915308",
            "telephone_number": "318-388-4863",
            "fax_number": "318-388-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLYDE E. ELLIOTT, M. D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-388-4863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "LA",
            "license": "10533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarence Lee Clay II, MS
• Katherine Clement
• Christina Carol Clements, M.A., LPC
• Clintox Laboratories, LLC
• Kim Cloe, M.S.,LPC
• Jeremy Cobb
• Cobb'S Pharmacy LLC
• Leslie Robin Coffman, M.D.
• Angela Coker, MS CCC-SLP
• Shirley Coker, LPC

• Addiction Medicine (Family Medicine) Physician in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Addiction Medicine (Family Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.