Individual
JOHN ELLIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 MARKET BLVD STE 105, COLLIERVILLE, TN 38017-2360
(901) 457-2880
(901) 457-2881
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15145
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007859
—
TN
Enumeration date
07/11/2005
Last updated
03/28/2025
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