# JOHN WILLIAM ELLIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1285631242
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3881 | AZ | Yes |

## Other

- **Enumeration date:** 07/06/2005
- **Last updated:** 07/30/2019

## 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 |