Elliott, Clyde Dale

Elliott, Clyde Dale is an individual health care provider with primary practice located at 1022 1St St N Suite 500, Alabaster AL 35007-8706. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Elliott, Clyde Dale can be contacted via phone (205) 663-5775.

Contact Information

Primary practice address
1022 1St St N Suite 500 Alabaster AL 35007-8706
Fax: (205) 664-2112
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 6974 Alabama

Profile Details

NPI number 1124005673
LBN Legal business name Elliott, Clyde Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Jul 21st, 2010 - about 16 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 1124005673 NPPES
Alabama MEDICAID 051552706

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