Eller, Ronald

Eller, Ronald is an individual health care provider with primary practice located at 971 Lakeland Dr Ste 657 , Jackson MS 39216-4608. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Eller, Ronald can be contacted via phone (601) 200-2780.

Contact Information

Primary practice address
971 Lakeland Dr Ste 657 Jackson MS 39216-4608
Phone: (601) 200-2780
Fax: (601) 200-2788
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA033 Mississippi

Profile Details

NPI number 1518992833
LBN Legal business name Eller, Ronald
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Feb 26th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518992833 NPPES
Mississippi Other 413906650 BCBS
Mississippi MEDICAID 00385756 BCBS

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