Ellis, Michael Alan

Ellis, Michael Alan is an individual health care provider with primary practice located at 2000 16Th Avenue , Columbus GA 31901-1665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Ellis, Michael Alan can be contacted via phone (706) 320-3770.

Contact Information

Primary practice address
2000 16Th Avenue Columbus GA 31901-1665
Phone: (706) 320-3770
Fax: (706) 320-3772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 1014 South Carolina
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 062835 Georgia

Profile Details

NPI number 1003981671
LBN Legal business name Ellis, Michael Alan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated Aug 2nd, 2015 - about 9 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 1003981671 NPPES
Alabama MEDICAID 112485
Alabama MEDICAID 216425865A

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