Ellis, Ethan R
Ellis, Ethan R is an individual health care provider with primary practice located at 2121 E Harmony Rd Ste 100, Fort Collins CO 80528-3400. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Ellis, Ethan R can be contacted via phone (970) 221-1000.Contact Information
Primary practice address
2121 E Harmony Rd Ste 100
Fort Collins CO 80528-3400
Phone: (970) 221-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | DR.0053902 | Colorado |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 27958 | Nebraska |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 235720 | Massachusetts |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | DR.0053902 | Colorado |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | DR.0053902 | Colorado |
Profile Details
| NPI number | 1316110208 |
|---|---|
| LBN Legal business name | Ellis, Ethan R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2008 |
| Last updated | Mar 28th, 2016 - about 9 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 | 1316110208 | NPPES |
| Colorado | MEDICAID | 87529351 |
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