Individual
WARREN R ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8924
Mailing address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8924
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
26121-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023
DEAN HEALTH INSURANCE
WI
05
—
30578500
—
WI
Enumeration date
06/07/2006
Last updated
01/03/2014
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