Individual
DR. CHRISTIAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4140 W MEMORIAL RD, STE. 621, OKLAHOMA CITY, OK 73120-8366
(405) 749-4231
(405) 749-4234
Mailing address
4401 W MEMORIAL RD, OKLAHOMA CITY, OK 73134-1785
(405) 749-4231
(405) 749-4234
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
3660
OK
208600000X
Surgery Physician
Primary
3660
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200084540A
—
OK
01
—
P00690379
RR MEDICARE
—
Enumeration date
06/22/2005
Last updated
01/31/2018
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