Individual
DAVID F ELLISON
Active
Individual
DAVID F ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO00749
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000380047C
—
GA
05
—
009602430
—
AL
01
—
050047705
MEDICARE RAILROAD
TN
01
—
3031773
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
05
—
3302285
—
TN
05
—
890550M
—
NC
Enumeration date
08/15/2006
Last updated
06/02/2008
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