Doctor Name: | NATHAN B ELIASON |
NPI Number: | 1073557583 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 7074A |
Business Practice Address: | 255 N 30th St Laramie, WY - 820725140 |
Business Phone Number: | 3077422141 |
Business Fax Number: | 3077429091 |
Mailing Address: | Po Box 270592, LOUISVILLE |
State: | CO |
Postal Code: | 800275009 |
Phone Number: | 4059475557 |
Fax Number: | 4059486507 |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 11/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 7074A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |