Ellerin, Bruce Elkin

Ellerin, Bruce Elkin is an individual health care provider with primary practice located at 721 Clinic Dr , Tyler TX 75701-2043. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Ellerin, Bruce Elkin can be contacted via phone (903) 535-6312.

Contact Information

Primary practice address
721 Clinic Dr Tyler TX 75701-2043
Phone: (903) 535-6312
Fax: (903) 535-6330
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X L8679 Texas

Profile Details

NPI number 1285635052
LBN Legal business name Ellerin, Bruce Elkin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Apr 19th, 2019 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1285635052 NPPES
Other 1825753 AETNA
MEDICAID 1984247-03 AETNA
MEDICAID 1984247-04 AETNA
Other 010046338 AETNA
Other 3K8111 AETNA
Other P3883771 AETNA

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