Ellis, Daryl
Ellis, Daryl is an individual health care provider with primary practice located at 5009 River Chase Dr Suite 500, Phenix City AL 36867-7425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ellis, Daryl can be contacted via phone (334) 448-9505.Contact Information
Primary practice address
5009 River Chase Dr Suite 500
Phenix City AL 36867-7425
Phone: (334) 448-9505
Fax: (334) 448-9575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 00018084 | Alabama |
Profile Details
| NPI number | 1467468355 |
|---|---|
| LBN Legal business name | Ellis, Daryl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Nov 21st, 2012 - about 12 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 | 1467468355 | NPPES |
| Alabama | MEDICAID | 009997735 |
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