Individual
DR. WALTER WRIGHT ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3749 N CAUSEWAY BLVD, METAIRIE, LA 70002-2046
(504) 828-8241
(504) 828-8243
Mailing address
227 RIVERWOOD DR, SAINT ROSE, LA 70087-3765
(504) 469-3438
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
024782
LA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
024782
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1489417
—
LA
Enumeration date
12/24/2006
Last updated
10/10/2019
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