Ellis, Paul Devere

Ellis, Paul Devere is an individual health care provider with primary practice located at 11459 Johns Creek Pkwy Ste 250, Johns Creek GA 30097-3517. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ellis, Paul Devere can be contacted via phone (770) 497-1555.

Contact Information

Primary practice address
11459 Johns Creek Pkwy Ste 250 Johns Creek GA 30097-3517
Fax: (770) 497-9998
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 041549 Georgia

Profile Details

NPI number 1740297811
LBN Legal business name Ellis, Paul Devere
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated May 5th, 2016 - about 10 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 1740297811 NPPES
Georgia MEDICAID 00701918B

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