Elliott, Daniel O.
Elliott, Daniel O. is an sole proprietor health care provider with primary practice located at 220 N Ironwood Dr , South Bend IN 46615-2518. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Elliott, Daniel O. can be contacted via phone (574) 233-3617.Contact Information
Primary practice address
220 N Ironwood Dr
South Bend IN 46615-2518
Phone: (574) 233-3617
Fax: (574) 280-7355
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | IN18001717B | Indiana |
Profile Details
| NPI number | 1083614267 |
|---|---|
| LBN Legal business name | Elliott, Daniel O. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Dec 11th, 2012 - about 14 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 | 1083614267 | NPPES |
| Indiana | MEDICAID | 100221940A |
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