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Individual

DR. PANAYIOTIS A ELLINAS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
100 E 5TH ST, CQCH BILLING DEPT, DOUGLAS, AZ 85607-2859
(520) 364-7659
Mailing address
101 COLE AVE, CQCH BILLING DEPT, BISBEE, AZ 85603-1327
(520) 432-6452
(520) 432-8018

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
23114
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
322214
AZ
Enumeration date
08/03/2005
Last updated
07/31/2015
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