Ellis, Eric R
Ellis, Eric R is an individual health care provider with primary practice located at 605 Glenwood Drive Suite 200, Chattanooga TN 37404-1130. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Ellis, Eric R can be contacted via phone (423) 698-1844.Contact Information
Primary practice address
605 Glenwood Drive Suite 200
Chattanooga TN 37404-1130
Phone: (423) 698-1844
Fax: (423) 624-2226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD0000019592 | Tennessee |
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | MD0000019592 | Tennessee |
Profile Details
| NPI number | 1477528644 |
|---|---|
| LBN Legal business name | Ellis, Eric R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Jan 28th, 2013 - 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 | 1477528644 | NPPES |
| Tennessee | MEDICAID | 3047073 |
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