Individual
RICHARD LEROY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2657 PARK LANE CT EAST--UNIT F, BIRMINGHAM, AL 35223
(205) 879-1386
Mailing address
2657 PARK LANE CT EAST--UNIT F, BIRMINGHAM, AL 35223
(205) 879-1386
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
DO145
AL
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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