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NPI Code Detail

MEDICARE: DR. JAMES V ELLIS MD

MEDICARE: DR. JAMES V ELLIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician13775TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578566733
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES V ELLIS MD
Provider Business Mailing Address
First Line : 5674 CLEAVES DR
Second Line : 105
City : ARLINGTON
State : TN
Zip : 38002-4564
Country : US
Telephone Number : 901-317-7360
Fax Number : 901-317-7585
Provider Business Practice Location Address
First Line : 3000 GETWELL RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38118-2205
Country : US
Telephone Number : 901-369-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 03/26/2015

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