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Individual
JOHN WILLIAM ELLIS
Active
Individual
JOHN WILLIAM ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3881
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2024711
CIGNA
AZ
01
—
2103583
FIRST HEALTH
AZ
01
—
2Z0278
HEALTH NET
AZ
01
—
5469474
CCN
AZ
01
—
56VMVZ
UHC
AZ
01
—
7448458
AETNA
AZ
05
—
783789
—
AZ
01
—
81060639601
PACIFICARE
AZ
01
—
81060639685308A002
CHAMPUS
AZ
01
—
922345
USA
AZ
01
—
AZ0733980
BC/BS
AZ
01
—
PROV000061230
SCHALLER ANDERSON
AZ
Enumeration date
07/06/2005
Last updated
07/30/2019
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