Provider Demographics
NPI:1902069560
Name:ELLIOTT, JAMES W (RRT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 WINDSONG CIR
Mailing Address - Street 2:
Mailing Address - City:BELDEN
Mailing Address - State:MS
Mailing Address - Zip Code:38826-8861
Mailing Address - Country:US
Mailing Address - Phone:662-840-8336
Mailing Address - Fax:
Practice Address - Street 1:204 INTERCHANGE DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-6011
Practice Address - Country:US
Practice Address - Phone:662-862-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSRCP1464227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered