Individual
WILLIAM ELLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2927 N 7TH AVE, PHOENIX, AZ 85013-4102
(602) 406-3153
(602) 406-7176
Mailing address
FILE 56765, LOS ANGELES, CA 90074-6765
(602) 406-3860
(602) 406-6132
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28129
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498370
—
AZ
Enumeration date
05/30/2006
Last updated
04/27/2012
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