Provider Demographics
NPI:1356903322
Name:ELLIOTT, GARY T (PHARMD, PHD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:T
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8236 COUNTY ROAD 74
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-2608
Mailing Address - Country:US
Mailing Address - Phone:858-414-7222
Mailing Address - Fax:
Practice Address - Street 1:8236 COUNTY ROAD 74
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-2608
Practice Address - Country:US
Practice Address - Phone:858-414-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study