Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 01027758A | IN |
NPI | 1033212238 |
---|---|
Provider Name | Dr. Craig Baity Elliott |
First Address | Danville, IL 61832-5100 |
Second Address | Danville, IL 61832-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |