Ellis, Jon Michael

Ellis, Jon Michael is an individual health care provider with primary practice located at 140 Hillcrest Medical Blvd Ste 2 , Waco TX 76712-8897. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Ellis, Jon Michael can be contacted via phone (254) 741-1400.

Contact Information

Primary practice address
140 Hillcrest Medical Blvd Ste 2 Waco TX 76712-8897
Phone: (254) 741-1400
Fax: (254) 741-1428
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X J9580 Texas

Profile Details

NPI number 1982600193
LBN Legal business name Ellis, Jon Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Sep 25th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982600193 NPPES
Texas MEDICAID 046446302

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