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Individual

EDWARD STEPHEN ELLIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
110 DEER XING, VONORE, TN 37885-2133
(423) 884-6958
(423) 884-6959
Mailing address
7317 PARLIAMENT DR, KNOXVILLE, TN 37919-7212
(865) 690-2759

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD0000012142
TN
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
MD0000012142
TN
2083X0100X
Occupational Medicine Physician
Primary
MD0000012142
TN

Other

Enumeration date
03/09/2006
Last updated
09/11/2025
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