Individual
DR. BRIAN E ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 DANIEL DR, DANVILLE, KY 40422-2527
(859) 236-3361
(859) 239-9484
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
(859) 236-3361
(859) 239-9484
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29363
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64293632
—
KY
Enumeration date
08/09/2006
Last updated
08/30/2011
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