Ellis, Christian
Ellis, Christian is an individual health care provider with primary practice located at 4140 W Memorial Rd Ste. 621, Oklahoma City OK 73120-8366. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Ellis, Christian can be contacted via phone (405) 749-4231.Contact Information
Primary practice address
4140 W Memorial Rd Ste. 621
Oklahoma City OK 73120-8366
Phone: (405) 749-4231
Fax: (405) 749-4234
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM | 204D00000X | 3660 | Oklahoma |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 3660 | Oklahoma |
Profile Details
| NPI number | 1205832607 |
|---|---|
| LBN Legal business name | Ellis, Christian |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Jan 31st, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205832607 | NPPES |
| Other | P00690379 | RR MEDICARE | |
| MEDICAID | 200084540A | RR MEDICARE |
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