Healthcare Provider Details

I. General information

NPI: 1881616639
Provider Name (Legal Business Name): DEBORAH LOIS ELLIOTT-PEARSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH LOIS ELLIOTT

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 S 13TH ST
LIVINGSTON MT
59047-3727
US

IV. Provider business mailing address

504 S 13TH ST
LIVINGSTON MT
59047-3727
US

V. Phone/Fax

Practice location:
  • Phone: 406-222-3541
  • Fax: 406-823-6630
Mailing address:
  • Phone: 406-823-6414
  • Fax: 406-823-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM7469
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: