Individual
DR. GREGORY EUGENE ELLCESSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
3611 S REED RD STE 210, KOKOMO, IN 46902-3828
(765) 864-8925
(765) 864-8926
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002540A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247680
—
IN
Enumeration date
09/05/2013
Last updated
05/31/2023
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