Individual
COREY JAMES ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 E APPLE ST, SUITE 2200, DAYTON, OH 45409-2939
(937) 208-2091
(937) 208-6141
Mailing address
725 UNIVERSITY BLVD, DAYTON, OH 45435-0001
(937) 245-7100
(937) 245-7999
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35084741
OH
2080S0010X
Pediatric Sports Medicine Physician
35.084741
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2511446
—
OH
Enumeration date
04/26/2006
Last updated
11/20/2025
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