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1174513113
BERT CLAIR ELIASON
GALLUP, NM
NPI
1174513113
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036099778)
Enumeration Date
2005-10-21
Last Update Date
2023-03-07
Business Address
Dr. BERT CLAIR ELIASON M.D.
516 E. NIZHONI BLVD.
GALLUP, NM 87301-1337
Phone number: 505-722-1000
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Mailing Address
Dr. BERT CLAIR ELIASON M.D.
4185 LEIGH LANE
ALTA, WY 83414
Phone number: 801-471-8894
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