Individual
DAVID WILLIAM ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MS 515, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
41696
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910542
—
AL
05
—
03081001
—
MS
05
—
1409596
—
LA
05
—
200110020A
—
OK
05
—
220105
—
AZ
05
—
5441542
—
TN
05
—
7615993
—
NC
Enumeration date
12/13/2006
Last updated
09/28/2012
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