Ellis, Mark

Ellis, Mark is an sole proprietor health care provider with primary practice located at 12592 S 150 E , Draper UT 84020-8611. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Public Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Ellis, Mark can be contacted via phone (713) 377-2167.

Contact Information

Primary practice address
12592 S 150 E Draper UT 84020-8611
Phone: (713) 377-2167
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X 10105797-0501 Utah
Podiatric Medicine & Surgery Service Providers / Radiology 213ER0200X 10105797-0501 Utah
Podiatric Medicine & Surgery Service Providers / Public Medicine 213EP0504X 10105797-0501 Utah
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 10105797-0501 Utah
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0821 Arizona

Profile Details

NPI number 1972897080
LBN Legal business name Ellis, Mark
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2011
Last updated May 17th, 2018 - about 6 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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