Ellis, Richard K
Ellis, Richard K is an individual health care provider with primary practice located at 148 Sauls St , Lake City SC 29560-2631. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ellis, Richard K can be contacted via phone (843) 374-3621.Contact Information
Primary practice address
148 Sauls St
Lake City SC 29560-2631
Phone: (843) 374-3621
Fax: (843) 374-3624
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 21182 | South Carolina |
Profile Details
| NPI number | 1245336932 |
|---|---|
| LBN Legal business name | Ellis, Richard K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Dec 4th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245336932 | NPPES |
| South Carolina | MEDICAID | 211826 | |
| South Carolina | Other | P01055600 |
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