Ellison, Margarett Conklin

Ellison, Margarett Conklin is an individual health care provider with primary practice located at 3131 S Main St , Moultrie GA 31768-6925. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecologic Oncology, which is considered as her primary health care specialty. Ellison, Margarett Conklin can be contacted via phone (229) 890-3514.

Contact Information

Primary practice address
3131 S Main St Moultrie GA 31768-6925
Phone: (229) 890-3514
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X ME128607 Florida
Allopathic & Osteopathic Physicians / Gynecologic Oncology 207VX0201X 62837 Georgia

Profile Details

NPI number 1871591297
LBN Legal business name Ellison, Margarett Conklin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2005
Last updated May 23rd, 2024 - about 2 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 1871591297 NPPES
Georgia Other G372337856 MEDICARE PTAN
Georgia Other QW330 MEDICARE PTAN
Georgia MEDICAID 833679085P MEDICARE PTAN

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