Individual
WILLIAM TRAVIS ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2755 S HIGHWAY 14, SUITE 1200A, GREER, SC 29650-4902
(864) 879-7556
(864) 879-3693
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
100795
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100795
—
SC
05
—
82458
—
SC
01
—
P00804453
RAILROAD MEDICARE
SC
Enumeration date
12/01/2006
Last updated
12/28/2020
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