Individual
DR. MARC ELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 COMMON DR, EL PASO, TX 79936-5922
(915) 595-4375
(915) 595-4460
Mailing address
4800 N 22ND ST STE 210, PHOENIX, AZ 85016-4963
(915) 267-2020
(915) 595-4460
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L8680
TX
207W00000X
Ophthalmology Physician
MD2004-0199
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168080301
—
TX
05
—
17702003
—
NM
Enumeration date
05/12/2006
Last updated
04/07/2023
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