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Individual

DR. THOMAS E ELLWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
126 MISSOURI AVE, MCXP-CCS-CR, FORT LEONARD WOOD, MO 65473-8952
(573) 596-0417
(573) 596-0524
Mailing address
2864 WOODRUFF STREET MCXC-PCS-BHC, FORT BRAGG, NC 28310-0001
(910) 570-3077
(910) 643-4021

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101232718
VA
208000000X
Pediatrics Physician
2018-02231
NC

Other

Enumeration date
01/27/2006
Last updated
10/29/2021
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