Billy Merrill Elliott III
Physician Assistant, Medical in Jacksonville, FL. Individual provider (NPI-1).
NPI number1790243293
StatusActive
Last updated in NPPESSep 29, 2021
Details
- NPI
- 1790243293
- Entity type
- Individual (NPI-1)
- Name
- Billy Merrill Elliott III
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2019
- Certification date
- Sep 29, 2021
- Last updated
- Sep 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | FL | Yes |
| 146L00000X | Emergency Medical Technician, Paramedic | 525082 | FL |
Practice location
3625 University Blvd SJacksonville, FL 32216-4207
Phone 904-702-6089
Mailing address
11692 Tanager DrJacksonville, FL 32225-2570
Phone 904-654-8294
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