Individual
DR. JIMMY SCOTT ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
785 RUSSELL ST, SUITE 100, CRAIG, CO 81625-2019
(970) 826-2420
(970) 826-2429
Mailing address
785 RUSSELL ST, SUITE 100, CRAIG, CO 81625-2019
(970) 826-2420
(970) 826-2429
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
14709
SD
207V00000X
Obstetrics & Gynecology Physician
Primary
46656
CO
207V00000X
Obstetrics & Gynecology Physician
L6229
TX
207V00000X
Obstetrics & Gynecology Physician
OP61014771
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01936531
—
CO
01
—
133125100
FIRSTCARE & SW LIFE&HEALT
—
05
—
159097801
—
TX
05
—
1609891795
—
SD
01
—
311819386790650000
TRICARE
—
01
—
3277999
CIGNA
—
01
—
7431448
AETNA
—
01
—
8J3940
BCBS
TX
01
—
P00070099
RAILROAD MEDICARE
TX
Enumeration date
07/12/2006
Last updated
03/20/2025
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