| Jack Ellis I, PA-C | |
|
4141 N Hampton Dr Ste 200, Powell, OH 43065-7062 | |
| (614) 764-0200 | |
| Not Available |
| Full Name | Jack Ellis I |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 4141 N Hampton Dr Ste 200, Powell, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346962982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 50.007768RX (Ohio) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Ellis I, PA-C Po Box 7527, Dublin, OH 43017-0727 Ph: () - | Jack Ellis I, PA-C 4141 N Hampton Dr Ste 200, Powell, OH 43065-7062 Ph: (614) 764-0200 |
Kimberly Smith, Physician Assistant Medicare: Medicare Enrolled Practice Location: 120 E Olentangy St, Powell, OH 43065 Phone: 614-898-1211 Fax: 614-961-1096 | |
Jaid Gampp, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 9070 Sunrise Ridge Pl, Powell, OH 43065 Phone: 740-370-8875 | |
Ashley Suffoletto, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10330 Sawmill Pkwy, Suite 300, Powell, OH 43065 Phone: 614-794-0481 Fax: 614-794-3711 | |
Brooke Severance, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 9399 Wayne Brown Dr, Powell, OH 43065 Phone: 614-594-0578 |