Provider Demographics
NPI:1174942171
Name:ELLIOTT, JOHN LINTON JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LINTON
Last Name:ELLIOTT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HOWELL MILL RD NW
Mailing Address - Street 2:STE 175
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0924
Mailing Address - Country:US
Mailing Address - Phone:404-727-5658
Mailing Address - Fax:
Practice Address - Street 1:1800 HOWELL MILL RD NW
Practice Address - Street 2:STE 175
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0924
Practice Address - Country:US
Practice Address - Phone:404-727-5658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA75096207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program