Individual
ROSEGENEE MCLARIN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(770) 793-7899
(770) 793-7856
Mailing address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(770) 793-7899
(770) 793-7856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
062836
GA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
62836
GA
208M00000X
Hospitalist Physician
062836
GA
Other
Enumeration date
09/20/2006
Last updated
09/06/2023
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