WENDELL H ELLIOTT MD NPI 1730168592

NPI Information

  • NPI: 1730168592
  • Provider Name: WENDELL H ELLIOTT, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 686 LESTER ST
    POPLAR BLUFF, MO
    ZIP 63901
  • Phone: (573) 686-2411

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NPI Details

Wendell H Elliott, MD is a family medicine in Poplar Bluff, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Wendell H Elliott, MD NPI is 1730168592. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

686 LESTER ST
POPLAR BLUFF, MO
ZIP 63901-025
Phone: (573) 686-2411
Fax: (573) 686-8452

The NPI 1730168592 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/11/2006 and was last updated on 11/5/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineR5G12MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1080037682OTHERTRAVELERS MEDICARE
2A11644MEDICARE UPIN
320Z414900MEDICAIDMISSOURI
4000005608MEDICARE ID-TYPE UNSPECIFIED
5113765001MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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