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NPI Code Detail

MEDICARE: DR. MICHAEL SYDNEY ELLIS M.D.

MEDICARE: DR. MICHAEL SYDNEY ELLIS M.D.
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
1174400000XSpecialist010221LA
2207Y00000XOtolaryngology PhysicianMD.010221LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518961259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL SYDNEY ELLIS M.D.
Provider Business Mailing Address
First Line : 1415 TULANE AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70112-2600
Country : US
Telephone Number : 504-988-5451
Fax Number : 504-988-5948
Provider Business Practice Location Address
First Line : 1415 TULANE AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70112-2600
Country : US
Telephone Number : 504-988-5451
Fax Number : 504-988-5948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 04/19/2017

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