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Individual

HOWARD ROSS ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
665 DULUTH HWY STE 920, LAWRENCEVILLE, GA 30046
(678) 312-5250
Mailing address
PO BOX 1170, LAWRENCEVILLE, GA 30046-1170
(470) 325-0159
(470) 325-0191

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
50159
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000908432A
GA
Enumeration date
01/26/2007
Last updated
02/26/2021
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