| Doctor Name: | DAVID GRANT ELCOCK |
| NPI Number: | 1043273741 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 04-23256 |
| Business Practice Address: | 4101 S 4th St Leavenworth, KS - 660485014 |
| Business Phone Number: | 9136822000 |
| Business Fax Number: | |
| Mailing Address: | 4101 S 4th St, LEAVENWORTH |
| State: | KS |
| Postal Code: | 660485014 |
| Phone Number: | 9136822000 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 04-23256 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |