Individual
DR. EZRA DANIEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-1136
(770) 219-6204
Mailing address
PO BOX 3293, INDIANAPOLIS, IN 46206-3293
(317) 614-9863
(844) 876-0873
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2007-00176
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
70094
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
M-10161
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010167581
REGENCE BLUESHIELD OF IDAHO
ID
01
—
77342
BLUECROSS OF IDAHO
ID
05
—
808087600
—
ID
Enumeration date
11/13/2007
Last updated
10/28/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us