Individual
DR. JOHN ARTHUR ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 N PICKAWAY ST, CIRCLEVILLE, OH 43113-1447
(740) 474-2126
(740) 477-1022
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(934) 619-4366
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-00-6876
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372264
BLUE CROSS BLUE SHIELD
OH
05
—
2372838
—
OH
Enumeration date
12/16/2005
Last updated
08/09/2013
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