Individual
GERMAN ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-2296
Mailing address
30 N 1900 E, RM 1C412, SALT LAKE CITY, UT 84132-0002
(602) 839-2296
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R74408
AZ
2083X0100X
Occupational Medicine Physician
Primary
9560102-1205
UT
Other
Enumeration date
05/05/2014
Last updated
10/07/2023
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