Individual
GERRY FRANCIS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 13TH AVE SE, SUITE A, DECATUR, AL 35601-4359
(256) 355-9216
(256) 351-6327
Mailing address
1304 13TH AVE SE, SUITE A, DECATUR, AL 35601-4359
(256) 355-9216
(256) 351-6327
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
8779
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51003190
BLUE CROSS BLUE SHIELD
AL
01
—
52930017
GROUP ALABAMA MEDICAID
—
01
—
D578
GROUP MEDICARE
—
Enumeration date
12/13/2005
Last updated
12/03/2007
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