Individual
DR. GREGORY TAYLOR ELLISON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4750 WATERS AVE STE 500, SAVANNAH, GA 31404-6261
(912) 354-8346
Mailing address
4750 WATERS AVE STE 500, SAVANNAH, GA 31404-6261
(912) 354-8346
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
078538
GA
2086S0129X
Vascular Surgery Physician
51428
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003193042A
—
GA
05
—
GA2141
—
SC
Enumeration date
04/26/2012
Last updated
09/13/2022
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