Ellingson, Derek

Ellingson, Derek is an individual health care provider with primary practice located at 7950 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Ellingson, Derek can be contacted via phone (260) 435-7001.

Contact Information

Primary practice address
7950 W Jefferson Blvd Fort Wayne IN 46804-4140
Phone: (260) 435-7001
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X DO05260 Iowa
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MEDO7423 Alaska
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 2007018750 Missouri
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 02006527A Indiana

Profile Details

NPI number 1487848644
LBN Legal business name Ellingson, Derek
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2007
Last updated Aug 25th, 2021 - about 5 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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