Individual
JAMES WILEY ELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 N SUMTER ST, STE 300, SUMTER, SC 29150-4972
(803) 775-4655
(803) 775-7258
Mailing address
3555 HARDEN STREET EXT, 15 MEDICAL PARK, SUITE 300, COLUMBIA, SC 29203-6894
(803) 434-6412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7442
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074421
—
SC
Enumeration date
05/20/2006
Last updated
10/25/2016
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