Ellis, Lora Elizabeth

Ellis, Lora Elizabeth is an individual health care provider with primary practice located at 76 Remick Blvd , Springboro OH 45066-9168. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ellis, Lora Elizabeth can be contacted via phone (937) 885-4475.

Contact Information

Primary practice address
76 Remick Blvd Springboro OH 45066-9168
Fax: (937) 885-3670
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35086223 Ohio

Profile Details

NPI number 1629162458
LBN Legal business name Ellis, Lora Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - about 19 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 1629162458 NPPES
Ohio MEDICAID 2592690

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