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Individual

DR. BLESILDA Q ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1415 TULANE AVE FL 7, NEW ORLEANS, LA 70112-2600
(504) 988-8600
(504) 988-8688
Mailing address
PO BOX 7987, MOBILE, AL 36670-0987
(251) 633-0573
(251) 633-7367

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
27022
AL
207RP1001X
Pulmonary Disease Physician
27022
AL
207RP1001X
Pulmonary Disease Physician
Primary
MD.09330R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00118449
MS MEDICAID
MS
01
102I293263
MEDICARE
AL
05
168326
AL
01
1730048
UHC
AL
05
1972581
LA
05
203245
AL
05
205842
AL
05
211714
AL
05
213438
AL
01
511-56774
BCBS
AL
01
511-56775
BCBS
AL
01
511-57064
BCBS
AL
01
511-95544
BCBS
AL
01
512-05526
BCBS
AL
01
512-05528
BCBS
AL
01
5779364
AETNA
AL
01
7718053
CIGNA HC
AL
01
F68986
VIVA HEALTH
AL
01
P01438825
RR MEDICARE
AL
Enumeration date
07/06/2006
Last updated
03/04/2024
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