Ellis, William W
Ellis, William W is an individual health care provider with primary practice located at 116 Mimosa Dr , Thomasville GA 31792-6605. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Ellis, William W can be contacted via phone (229) 551-0083.Contact Information
Primary practice address
116 Mimosa Dr
Thomasville GA 31792-6605
Phone: (229) 551-0083
Fax: (229) 227-9642
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 015666 | Georgia |
Profile Details
| NPI number | 1073515300 |
|---|---|
| LBN Legal business name | Ellis, William W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2005 |
| Last updated | Nov 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073515300 | NPPES |
| Georgia | MEDICAID | 00264195A |
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