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:
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Health care specialties

SpecialtyCodeLicense #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 4 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 1093762908 NPPES
Nevada MEDICAID 1093762908

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