Healthcare Provider Details

I. General information

NPI: 1811491061
Provider Name (Legal Business Name): JOHN FRANKLIN ELLWOOD JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

13415 JUDY AVE NW
UNIONTOWN OH
44685-9311
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3361
  • Fax:
Mailing address:
  • Phone: 330-807-6401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.410842
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN.410842
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: