Provider Demographics
NPI:1811936107
Name:ELLIOTT, ALAN L (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:L
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1035 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-7908
Mailing Address - Country:US
Mailing Address - Phone:423-826-0800
Mailing Address - Fax:423-826-0810
Practice Address - Street 1:1035 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-7908
Practice Address - Country:US
Practice Address - Phone:423-826-0800
Practice Address - Fax:423-826-0810
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN50870207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH54188Medicare UPIN