Individual
DR. THOMAS W. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 HENNESSY BLVD, BATON ROUGE, LA 70808-4300
(225) 765-7163
Mailing address
DEPT AT952639, ATLANTA, GA 31192-2639
(800) 684-0857
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.206063
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2322001
—
LA
01
—
P01238249
RAILROAD MCARE
LA
Enumeration date
01/03/2007
Last updated
01/15/2014
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