Individual
ANDREW ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 W 4TH ST, ADA, OK 74820-3411
(580) 257-2444
(580) 257-2445
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 319-7305
(580) 319-7328
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/30/2026
Last updated
01/30/2026
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