Ellis, Colette Mark

Ellis, Colette Mark is an individual health care provider with primary practice located at 1059 Baywood Dr , Fairborn OH 45324-2647. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Ellis, Colette Mark can be contacted via phone (713) 339-0341.

Contact Information

Primary practice address
1059 Baywood Dr Fairborn OH 45324-2647
Phone: (713) 339-0341
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X S8030 Texas
Allopathic & Osteopathic Physicians / General Practice 208D00000X S8030 Texas

Profile Details

NPI number 1629530225
LBN Legal business name Ellis, Colette Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2019
Last updated Jul 27th, 2022 - about 3 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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