MEDICARE: DR. ROBERT NEIL ELLIOTT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	01056931A	IN
2	207R00000X	Internal Medicine Physician	01056931A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00732683	OTHER	IN	MEDICARERR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000598991	OTHER	IN	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000983472	OTHER	IN	ANTHEM PIN
4	1396910139	OTHER	IN	GRP NPI

General Provider Information

NPI Number	:	1629072517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT NEIL ELLIOTT M.D.

Provider Business Mailing Address
First Line	:	411 PLAZA DR
Second Line	:	SUITE H
City	:	COLUMBUS
State	:	IN
Zip	:	47201-2916
Country	:	US
Telephone Number	:	812-376-5974
Fax Number	:	812-375-3203

Provider Business Practice Location Address
First Line	:	2400 17TH ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201
Country	:	US
Telephone Number	:	812-376-5974
Fax Number	:	812-375-3203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	08/13/2018

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Directions to “ DR. ROBERT NEIL ELLIOTT M.D.” Practice Location

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