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:
Health care specialties
Specialty | Code | License # | 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 6 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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