Ellis, James R

Ellis, James R is an individual health care provider with primary practice located at 1111 Leffingwell Ave Ne Ste 100, Grand Rapids MI 49525-6406. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Ellis, James R can be contacted via phone (616) 459-7101.

Contact Information

Primary practice address
1111 Leffingwell Ave Ne Ste 100 Grand Rapids MI 49525-6406
Phone: (616) 459-7101
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 4301058854 Michigan

Profile Details

NPI number 1710975156
LBN Legal business name Ellis, James R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Jan 29th, 2013 - about 11 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 1710975156 NPPES
Michigan MEDICAID 3184402

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