Ellis, Jeffrey Warren

Ellis, Jeffrey Warren is an individual health care provider with primary practice located at 2701 Meredyth Dr , Albany GA 31707-2267. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Ellis, Jeffrey Warren can be contacted via phone (229) 430-9213.

Contact Information

Primary practice address
2701 Meredyth Dr Albany GA 31707-2267
Phone: (229) 430-9213
Fax: (229) 903-1585
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 034582 Georgia
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 4301071108 Michigan
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01047231A Indiana

Profile Details

NPI number 1093860090
LBN Legal business name Ellis, Jeffrey Warren
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2007
Last updated Apr 10th, 2023 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1093860090 NPPES
Indiana MEDICAID 200299850
Indiana Other P01723961

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