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Individual

DR. JONATHAN D ELLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4441 E LOHMAN AVE, LAS CRUCES, NM 88011-8267
(901) 484-2052
Mailing address
PO BOX 1000 DEPT 0420, MEMPHIS, TN 38148-0420
(901) 484-2052
(901) 507-8298

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
26906
TN

Other

Enumeration date
09/14/2006
Last updated
10/24/2024
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