| David J. Ellis, Do, Llc | |
|
143 S Tallahassee St Hazlehurst GA 31539-6466 | |
| (912) 375-7575 | |
| (912) 375-7553 |
| Full Name | David J. Ellis, Do, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 143 S Tallahassee St, Hazlehurst, Georgia |
| Authorized Official Name and Position | David J Ellis (PHYSICIAN) |
| Authorized Official Contact | 9123757575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David J. Ellis, Do, Llc Po Box 4207 Macon GA 31208-4207 Ph: (912) 375-7575 | David J. Ellis, Do, Llc 143 S Tallahassee St Hazlehurst GA 31539-6466 Ph: (912) 375-7575 |
| NPI Number | 1356495238 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356495238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 020865 (Georgia) | Primary |
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