# ELLIS CLINIC, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316134141
- **Authorized official:** DR. JOHN W. ELLIS M.D. (PRESIDENT)
- **Authorized official phone:** (405) 917-5336

## Contact information

- **Practice address:** 5100 N BROOKLINE AVE STE 465, OKLAHOMA CITY, OK 73112-3625
- **Practice address phone:** (405) 917-5336
- **Practice address fax:** (405) 917-2250
- **Mailing address:** 5100 N BROOKLINE AVE STE 465, OKLAHOMA CITY, OK 73112-3625
- **Mailing address phone:** (405) 917-5336
- **Mailing address fax:** (405) 917-2250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/25/2007
- **Last updated:** 09/25/2007