Ellis, Michael Barry

Ellis, Michael Barry is an sole proprietor health care provider with primary practice located at 1008 Mission Park Dr , Vicksburg MS 39180-3735. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ellis, Michael Barry can be contacted via phone (601) 629-4100.

Contact Information

Primary practice address
1008 Mission Park Dr Vicksburg MS 39180-3735
Phone: (601) 629-4100
Fax: (601) 629-4101
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 204783 Mississippi

Profile Details

NPI number 1619995743
LBN Legal business name Ellis, Michael Barry
Credentials D.M.D.,P.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 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.

Request for update

Popular Providers