Richard Alan Ellis M.D,

LBN: Richard Alan Ellis M.D,
Richard Alan Ellis M.D, is an health care organization with primary practice located at 3066 Fountainside Dr Ste 102 , Germantown TN 38138-7820. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. Richard Alan Ellis M.D, can be contacted via phone (901) 755-7335, or through Ellis, Donica Woods via phone (901) 755-7069.

Contact Information

Primary practice address
3066 Fountainside Dr Ste 102 Germantown TN 38138-7820
Phone: (901) 755-7335
Fax: (901) 755-7380
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Donica Woods Registered Nurse (RN)
Phone: (901) 755-7069

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD016474 Tennessee

Profile Details

NPI number 1033412846
LBN Legal business name Richard Alan Ellis M.D,
DBA Doing business as
Authorized official Ellis, Donica Woods Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2010
Last updated Jan 16th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033412846 NPPES
Tennessee Other 3026121 TENNESSEE MEDICAID

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