Ellis, Thomas W

Ellis, Thomas W is an sole proprietor health care provider with primary practice located at 2863 Highwy 45 Byp , Jackson TN 38305-3618. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Ellis, Thomas W can be contacted via phone (731) 422-0213.

Contact Information

Primary practice address
2863 Highwy 45 Byp Jackson TN 38305-3618
Phone: (731) 422-0213
Fax: (731) 422-0410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X MD8209 Tennessee
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD8209 Tennessee

Profile Details

NPI number 1932147774
LBN Legal business name Ellis, Thomas W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 3rd, 2006
Last updated Oct 25th, 2023 - about 3 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 1932147774 NPPES
Tennessee MEDICAID 31909201

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