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General NPI Number Information
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NPI Number | 1952212342
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Entity Type | Organization
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Legal Business Name | ELLERHORST MEDICAL, LLC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 1 MEMORY LN STE 200
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City | GARRETTSVILLE
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State | OH
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Zip | 44231-9415
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Country | US
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Telephone | 330-527-4852
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Fax | 330-527-4866
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Provider Business Mailing Address
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Address Line | 1 MEMORY LN STE 200
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City | GARRETTSVILLE
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State | OH
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Zip | 44231-9415
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Country | US
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Telephone | 330-527-4852
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Fax | 330-527-4866
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY ELLERHORST
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Credential | DO
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Telephone | 330-235-3448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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