Ellis, Dunk A.
Ellis, Dunk A. is an sole proprietor health care provider with primary practice located at 3736 Main St , Moss Point MS 39563-5108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ellis, Dunk A. can be contacted via phone (228) 474-2212.Contact Information
Primary practice address
3736 Main St
Moss Point MS 39563-5108
Phone: (228) 474-2212
Fax: (228) 475-6271
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 12710 | Mississippi |
Profile Details
| NPI number | 1043342322 |
|---|---|
| LBN Legal business name | Ellis, Dunk A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Jan 6th, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043342322 | NPPES |
| Mississippi | MEDICAID | 00113221 |
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