Jeri Ellis Md Mph Pc

LBN: Jeri Ellis Md Mph Pc
Jeri Ellis Md Mph Pc is an health care organization with primary practice located at 5835 S Pennsylvania Ave , Oklahoma City OK 73119-7001. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Jeri Ellis Md Mph Pc can be contacted via phone (405) 816-3311, or through Ellis, Jeri via phone (405) 604-9595.

Contact Information

Primary practice address
5835 S Pennsylvania Ave Oklahoma City OK 73119-7001
Phone: (405) 816-3311
Fax: (405) 634-7577
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Jeri Doctor of Medicine (MD)
Phone: (405) 604-9595

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20048 Oklahoma

Profile Details

NPI number 1043361934
LBN Legal business name Jeri Ellis Md Mph Pc
DBA Doing business as
Authorized official Ellis, Jeri Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 16th, 2007
Last updated May 2nd, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043361934 NPPES
Oklahoma Other 569535528001 BCBS
Oklahoma MEDICAID 200049610A BCBS
Oklahoma MEDICAID 200075590B BCBS

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