Elie Elovic MD LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

7277536-1205 Issued in UT

Legal business name

ELIE ELOVIC MD LLC

Practice address

8074 S 1300 E
Sandy, UT 84094-0743

Phone

(801) 565-6739

Fax

(801) 942-0607

NPI assigned

Apr 11, 2012

Organization subpart

No

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

Authorized official

Name

Elie Elovic, MD

Title

Owner

Phone

(801) 565-6739

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1326305673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8074 S 1300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840940743",
            "telephone_number": "801-565-6739",
            "fax_number": "801-942-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIE ELOVIC MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "ELOVIC",
        "authorized_official_first_name": "ELIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-565-6739",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "7277536-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.