Ellis, Wendell K
Ellis, Wendell K is an individual health care provider with primary practice located at 682 Hemlock Street Suite 490, Macon GA 31201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Ellis, Wendell K can be contacted via phone (478) 741-1208.Contact Information
Primary practice address
682 Hemlock Street Suite 490
Macon GA 31201
Phone: (478) 741-1208
Fax: (478) 741-1557
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 062202 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 062202 | Georgia |
Profile Details
| NPI number | 1093875973 |
|---|---|
| LBN Legal business name | Ellis, Wendell K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 11th, 2006 |
| Last updated | Mar 13th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093875973 | NPPES |
| Georgia | MEDICAID | 795311786B |
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