Individual
DR. JEFFREY COWAN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3344 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
(479) 521-8200
(479) 582-7310
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25527
AR
207RG0100X
Gastroenterology Physician
Primary
E-6356
AR
Other
Enumeration date
09/01/2007
Last updated
11/02/2021
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