Individual
JACOB LOUIS EZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Mailing address
1619 N COLLEGE AVE, UNIT 1, INDIANAPOLIS, IN 46202-1752
(317) 459-1862
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35.132189
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
35.132189
OH
390200000X
Student in an Organized Health Care Education/Training Program
0002216264
IN
Other
Enumeration date
03/26/2015
Last updated
08/12/2021
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