Provider Demographics
NPI:1114918109
Name:ELLIOTT, NORMAN LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:LYNN
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1355 PEACHTREE ST NE STE 1600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3276
Mailing Address - Country:US
Mailing Address - Phone:678-223-7774
Mailing Address - Fax:678-223-7799
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1600
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2209
Practice Address - Country:US
Practice Address - Phone:404-881-1094
Practice Address - Fax:404-885-7777
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA21679207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00228159HMedicaid
GA00228159HMedicaid
GA10BBBVVMedicare ID - Type Unspecified