Ellison, Jason M

Ellison, Jason M is an individual health care provider with primary practice located at 1072 N Liberty St Ste 200, Boise ID 83704. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Ellison, Jason M can be contacted via phone (208) 302-4600.

Contact Information

Primary practice address
1072 N Liberty St Ste 200 Boise ID 83704
Phone: (208) 302-4600
Fax: (208) 302-4655
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M10380 Idaho
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X M-10380 Idaho

Profile Details

NPI number 1740231455
LBN Legal business name Ellison, Jason M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Apr 25th, 2018 - about 7 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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