Individual
DR. CARL ELLISON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6161 S YALE AVE, CHUCC, TULSA, OK 74136-1902
(918) 494-2553
(918) 494-2547
Mailing address
6161 S YALE AVE, ACCOUNTING, TULSA, OK 74136-1902
(918) 494-2553
(918) 494-2547
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16061
OK
Other
Enumeration date
10/05/2005
Last updated
07/08/2007
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