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NPI Code Detail

MEDICARE: MICHAEL ELLIOTT

MEDICARE: MICHAEL ELLIOTT
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
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1558225698
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ELLIOTT
Provider Business Mailing Address
First Line : PO BOX 132
Second Line :
City : ATHENS
State : OH
Zip : 45701-0132
Country : US
Telephone Number : 800-321-8293
Fax Number :
Provider Business Practice Location Address
First Line : 11 GRAHAM DR
Second Line :
City : ATHENS
State : OH
Zip : 45701-1430
Country : US
Telephone Number : 800-321-8293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ MICHAEL ELLIOTT ” Practice Location

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