Ellis, Joe E

Ellis, Joe E is an individual health care provider with primary practice located at 109 W 5Th St , Benton KY 42025-1123. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Other Service Providers / Specialist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Ellis, Joe E can be contacted via phone (270) 527-7421.

Contact Information

Primary practice address
109 W 5Th St Benton KY 42025-1123
Phone: (270) 527-7421
Fax: (270) 527-3118
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1073DT Kentucky
Other Service Providers / Specialist 174400000X 1073DT Kentucky

Profile Details

NPI number 1174597934
LBN Legal business name Ellis, Joe E
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Mar 7th, 2023 - about 2 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 1174597934 NPPES
Kentucky Other 149794 HEALTHLINK
Kentucky MEDICAID 77010734 HEALTHLINK
Kentucky Other 000000053519 HEALTHLINK
Kentucky Other 4349131 HEALTHLINK
Kentucky Other T54572 HEALTHLINK

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