Organization
MARK A ELLIS, MD, PC
Active
Other names
ELLIS PAIN MANAGEMENT
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A ELLIS MD (PRESIDENT)
(706) 208-0451
Entity
Organization
Contact information
Practice address
1500 LANGFORD MEDICAL DRIVE, SUITE 200, BOGART, GA 30622-6220
(706) 208-0451
(706) 208-0147
Mailing address
PO BOX 7577, ATHENS, GA 30604-7577
(706) 208-0451
(706) 208-0147
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
GA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
GA
Other
Enumeration date
02/01/2006
Last updated
07/21/2022
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