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Organization
JONATHAN ELLEN MD PC
Active
Organization
JONATHAN ELLEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ELLEN MD (OWNER/MANAGER)
(575) 521-4600
Entity
Organization
Contact information
Practice address
4441 E LOHMAN AVE, LAS CRUCES, NM 88011-8267
(901) 484-2052
Mailing address
PO BOX 1000 DEPT 0420, MEMPHIS, TN 38148-0420
(901) 821-0338
(901) 821-0341
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
10/24/2024
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