Individual
JOHN WILLIAM ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6320 W UNION HILLS DR STE 2800B, GLENDALE, AZ 85308-1380
(623) 322-4991
(623) 322-9568
Mailing address
6320 W UNION HILLS DR STE 2800B, GLENDALE, AZ 85308-1380
(623) 322-4991
(623) 322-9568
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3881
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2024711
CIGNA
AZ
01
—
2103583
FIRST HEALTH
AZ
01
—
2Z0278
HEALTH NET
AZ
01
—
5469474
CCN
AZ
01
—
56VMVZ
UHC
AZ
01
—
7448458
AETNA
AZ
05
—
783789
—
AZ
01
—
81060639601
PACIFICARE
AZ
01
—
81060639685308A002
CHAMPUS
AZ
01
—
922345
USA
AZ
01
—
AZ0733980
BC/BS
AZ
01
—
PROV000061230
SCHALLER ANDERSON
AZ
Enumeration date
07/06/2005
Last updated
07/30/2019
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