Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 5783 | OK |
NPI | 1154381242 |
---|---|
Provider Name | Dr. Colin Hill Eliot |
First Address | Enid, OK 73701-6155 |
Second Address | Enid, OK 73701-6155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 13/03/2019 |