Provider Demographics
NPI:1477658540
Name:ELLIOTT MCDONAGH, TRICIA BUTTON (MD)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:BUTTON
Last Name:ELLIOTT MCDONAGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRICIA
Other - Middle Name:BUTTON
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:247 N FIREWEED ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7540
Mailing Address - Country:US
Mailing Address - Phone:907-262-8597
Mailing Address - Fax:907-262-6516
Practice Address - Street 1:247 N FIREWEED ST
Practice Address - Street 2:SUITE A
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7540
Practice Address - Country:US
Practice Address - Phone:907-262-8597
Practice Address - Fax:907-262-6516
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine