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Contact Information

CLARK A ELLIOTT, MD
1104 CASS ST
TRAVERSE CITY, MI49684-3236
 Phone: 231-941-1155
 Fax: 231-259-1005
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Pediatric Otolaryngology

207YP0228X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for CLARK A ELLIOTT · (Male)

NPI # 1871540567
Status Active
Credentials MD
Entity Individual
Enumeration date 05/28/2006
Last updated 01/16/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • KY License # 41717
  • ND License # 12266
Hospital affiliation(s)
  • OUR LADY OF LOURDES MEMORIAL HOSPITAL INC - (Acute Care)
    169 RIVERSIDE DRIVE
    BINGHAMTON, NY 13905
  • UNITED HEALTH SERVICES HOSPITALS INC - (Acute Care)
    33-57 HARRISON STREET
    JOHNSON CITY, NY 13790
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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