Elliot, Eric M

Elliot, Eric M is an individual health care provider with primary practice located at 888 Thackeray Trl Ste 103 , Oconomowoc WI 53066-4342. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Elliot, Eric M can be contacted via phone (262) 330-0062.

Contact Information

Primary practice address
888 Thackeray Trl Ste 103 Oconomowoc WI 53066-4342
Phone: (262) 330-0062
Fax: (262) 330-0062
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA850 Maine
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3443-23 Wisconsin

Profile Details

NPI number 1508825605
LBN Legal business name Elliot, Eric M
Credentials DMSC, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Mar 3rd, 2025 - about last year

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 1508825605 NPPES
Maine MEDICAID 1023800100
Maine MEDICAID 154420000

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