Individual
DR. JOHN WESLEY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5100 N BROOKLINE AVE STE 465, OKLAHOMA CITY, OK 73112-3625
(405) 917-5336
(405) 917-2250
Mailing address
5100 N BROOKLINE AVE STE 465, OKLAHOMA CITY, OK 73112-3625
(405) 917-5336
(405) 917-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9024
OK
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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