Organization
GEORGE G ELLIS JR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORRAINE ELLIS (OFFICE MANAGER)
(330) 965-0832
Entity
Organization
Contact information
Practice address
910 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4240
(330) 965-0832
(330) 965-0155
Mailing address
910 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4240
(330) 965-0832
(330) 965-0155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35060641E
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0894500
—
OH
05
—
2316989
—
OH
Enumeration date
09/11/2007
Last updated
09/19/2024
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