Organization
HOWARD S ELLISON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY CHILDERS LISTER CPRP (OFFICE MANAGER)
(770) 922-8222
Entity
Organization
Contact information
Practice address
1010 EAST FREEWAY DR, CONYERS, GA 30094
(770) 922-8222
(770) 922-2001
Mailing address
1010 EAST FREEWAY DR, CONYERS, GA 30094
(770) 922-8222
(770) 922-2001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000193586A
—
GA
Enumeration date
06/18/2006
Last updated
07/26/2010
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