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NPI Code Detail

MEDICARE: GERRY FRANCIS ELLIS MD

MEDICARE: GERRY FRANCIS 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
1207V00000XObstetrics & Gynecology Physician8779AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D578OTHERGROUP MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
251003190OTHERALBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043295181
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERRY FRANCIS ELLIS MD
Provider Business Mailing Address
First Line : 1304 13TH AVE SE
Second Line : SUITE A
City : DECATUR
State : AL
Zip : 35601-4359
Country : US
Telephone Number : 256-355-9216
Fax Number : 256-351-6327
Provider Business Practice Location Address
First Line : 1304 13TH AVE SE
Second Line : SUITE A
City : DECATUR
State : AL
Zip : 35601-4359
Country : US
Telephone Number : 256-355-9216
Fax Number : 256-351-6327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 12/03/2007

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Directions to “ GERRY FRANCIS ELLIS MD” Practice Location

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