Individual
ALEX J ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01082621A
IN
2084N0400X
Neurology Physician
2012-01319
NC
Other
Enumeration date
06/23/2008
Last updated
01/26/2021
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