Provider Demographics
NPI:1518930627
Name:ELLIOTT, SEAN PATRICK (MD)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATRICK
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 31235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1235
Mailing Address - Country:US
Mailing Address - Phone:520-324-4100
Mailing Address - Fax:520-324-1406
Practice Address - Street 1:1500 N WILMOT RD STE B250
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4416
Practice Address - Country:US
Practice Address - Phone:520-324-7840
Practice Address - Fax:520-324-7839
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2021-08-19
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Provider Licenses
StateLicense IDTaxonomies
AZ279862080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ491027Medicaid