Healthcare Provider Details

I. General information

NPI: 1972506764
Provider Name (Legal Business Name): DAVID A EELLS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 JONES AVE
OAK HILL WV
25901-2909
US

IV. Provider business mailing address

330 FRANKLIN RD
BRENTWOOD TN
37027-3280
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-2500
  • Fax: 304-469-3399
Mailing address:
  • Phone: 615-309-3300
  • Fax: 615-309-3339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number14177
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: