Ellis, Shannon Scott

Ellis, Shannon Scott is an individual health care provider with primary practice located at 26 W Jackson Commons Dr , Hoschton GA 30548-1897. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ellis, Shannon Scott can be contacted via phone (706) 658-2452.

Contact Information

Primary practice address
26 W Jackson Commons Dr Hoschton GA 30548-1897
Phone: (706) 658-2452
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 072568 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2007-01049 North Carolina

Profile Details

NPI number 1124219563
LBN Legal business name Ellis, Shannon Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2007
Last updated Oct 6th, 2020 - about 5 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 1124219563 NPPES
North Carolina MEDICAID 5912656

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