Individual provider · Type 1 NPI

Jerrold Paul Elliott Iii, PA-C

Medical Physician Assistant · Guerneville, CA

NPI number 1982854618 Active

Practice location

16319 Third Street
Guerneville, CA 95446

Call (707) 869-5977 Map

Fax (707) 869-5983

Mailing address

PO Box 1449
Guerneville, CA 95446-1449

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X2666 (CO)
Medical Physician Assistant Primary 363AM0700XPA20527 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1982854618

Jerrold Paul Elliott Iii, PA-C's National Provider Identifier is 1982854618, issued on Sep 30, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Guerneville, CA. The record was last updated on Jan 25, 2021.