Edward Stephen Ellis, MD is a
Preventive Medicine - Occupational Medicine physician based in Vonore, Tennessee. Edward Stephen Ellis is licensed to practice in Tennessee (license number MD0000012142) and his current practice location is 110 Deer Xing, Vonore, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(423) 884-6958.
NPI number for Edward Stephen Ellis is 1376511931 and his current mailing address is 7317 Parliament Dr, Knoxville, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1376511931.
Physician's Profile
| Full Name | Edward Stephen Ellis |
|---|
| Gender | Male |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 110 Deer Xing, Vonore, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1376511931
- Provider Enumeration Date: 03/09/2006
- Last Update Date: 11/05/2021
Medical Identifiers
Medical identifiers for Edward Stephen Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376511931 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | MD0000012142 (Tennessee) | Primary |
| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | MD0000012142 (Tennessee) | Primary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | MD0000012142 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edward Stephen Ellis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Edward Stephen Ellis, MD
7317 Parliament Dr,
Knoxville, TN 37919-7212
Ph: (865) 690-2759 | Edward Stephen Ellis, MD
110 Deer Xing,
Vonore, TN 37885-2133
Ph: (423) 884-6958 |
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