Ellison, Jonathan

Ellison, Jonathan is an individual health care provider with primary practice located at 9000 W Wisconsin Ave , Milwaukee WI 53226-4874. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Urology. Allopathic & Osteopathic Physicians / Pediatric Urology is his primary health care specialty. Ellison, Jonathan can be contacted via phone (414) 266-3794.

Contact Information

Primary practice address
9000 W Wisconsin Ave Milwaukee WI 53226-4874
Phone: (414) 266-3794
Fax: (414) 266-1752
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301092616 Michigan
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X MD60449464 Washington
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X 69623 Wisconsin

Profile Details

NPI number 1861655581
LBN Legal business name Ellison, Jonathan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2008
Last updated Jun 13th, 2023 - about 2 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 1861655581 NPPES
Wisconsin MEDICAID 1861655581

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