Healthcare Provider Details

I. General information

NPI: 1215909585
Provider Name (Legal Business Name): FRANK SCOT ELLIOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 10/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 WIGWAM PKWY # 100
HENDERSON NV
89074-8162
US

IV. Provider business mailing address

1090 WIGWAM PKWY # 100
HENDERSON NV
89074-8162
US

V. Phone/Fax

Practice location:
  • Phone: 702-454-0201
  • Fax: 702-454-1245
Mailing address:
  • Phone: 702-454-0201
  • Fax: 702-454-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number15797
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME117433
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC54873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: