Individual
JEROME KEEFER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 CREE DR, LOCK HAVEN, PA 17745-2639
(570) 893-5000
Mailing address
24 CREE DR, LOCK HAVEN, PA 17745-2639
(570) 893-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD069228L
PA
208000000X
Pediatrics Physician
MD069228L
PA
Other
Enumeration date
03/31/2006
Last updated
09/11/2025
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