Individual
JENNIFER WATTERS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3773 OLENTANGY RIVER RD, COLUMBUS, OH 43214-3425
(614) 566-3861
(614) 566-3835
Mailing address
5400 FRANTZ RD STE 250, DUBLIN, OH 43016-6102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35076845
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2313366
—
OH
Enumeration date
04/08/2006
Last updated
01/25/2022
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