Individual
DR. ROBERT G ELLISON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
836 PRUDENTIAL DR, SUITE 1405, JACKSONVILLE, FL 32207-8334
(904) 388-7521
(904) 388-3541
Mailing address
836 PRUDENTIAL DR, SUITE 1405, JACKSONVILLE, FL 32207-8334
(904) 388-7521
(904) 388-3541
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME39556
FL
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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