Provider Demographics
NPI:1942629688
Name:ELLIOTT, IAIN S (MD)
Entity Type:Individual
Prefix:
First Name:IAIN
Middle Name:S
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W. CHARLESTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-383-2000
Mailing Address - Fax:
Practice Address - Street 1:3801 LAKE OTIS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5234
Practice Address - Country:US
Practice Address - Phone:907-562-2277
Practice Address - Fax:907-563-3460
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV21334207X00000X, 207XX0801X
WAMD60941394207X00000X
AK211451207XX0801X
WA1942629688207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1942629688Medicaid