Individual
JUSTINA MARIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
515 HOSPITAL DR STE 1, SHELBYVILLE, KY 40065-1619
(502) 633-3525
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0330
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
52870
KY
207Q00000X
Family Medicine Physician
Primary
52870
KY
Other
Enumeration date
03/23/2016
Last updated
11/30/2023
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