Ellison, David William

Ellison, David William is an individual health care provider with primary practice located at 262 Danny Thomas Pl , Memphis TN 38105-3678. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neuropathology, which is considered as his primary health care specialty. Ellison, David William can be contacted via phone (901) 595-3006.

Contact Information

Primary practice address
262 Danny Thomas Pl Memphis TN 38105-3678
Fax: (901) 595-3842
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuropathology 207ZN0500X 41696 Tennessee

Profile Details

NPI number 1912068669
LBN Legal business name Ellison, David William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Sep 28th, 2012 - about 12 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 1912068669 NPPES
Arizona MEDICAID 220105
Arizona MEDICAID 03081001
Arizona MEDICAID 1409596
Arizona MEDICAID 200110020A
Arizona MEDICAID 009910542
Arizona MEDICAID 5441542
Arizona MEDICAID 7615993

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