MEDICARE: LOIS A. ELLIOTT MD

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	207V00000X	Obstetrics & Gynecology Physician	42546	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	668587	OTHER	CO	BLUE CROSS/BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992729891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOIS A. ELLIOTT MD

Provider Business Mailing Address
First Line	:	931 LINCOLN ST
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3366
Country	:	US
Telephone Number	:	970-867-3885
Fax Number	:	970-867-3864

Provider Business Practice Location Address
First Line	:	931 LINCOLN ST
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3366
Country	:	US
Telephone Number	:	970-867-3885
Fax Number	:	970-867-3864

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	02/17/2011

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Directions to “ LOIS A. ELLIOTT MD” Practice Location

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