Ellis, Clyde Neal
Ellis, Clyde Neal is an individual health care provider with primary practice located at 2435 Fire Mesa St Ste 110A , Las Vegas NV 89128-9009. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Ellis, Clyde Neal can be contacted via phone (725) 200-3242.Contact Information
Primary practice address
2435 Fire Mesa St Ste 110A
Las Vegas NV 89128-9009
Phone: (725) 200-3242
Fax: (702) 664-3242
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 19367 | Nevada |
Profile Details
| NPI number | 1093762908 |
|---|---|
| LBN Legal business name | Ellis, Clyde Neal |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Oct 15th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093762908 | NPPES |
| Nevada | MEDICAID | 1093762908 |
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