Individual
JAMES STEPHEN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
626 1ST ST, MACON, GA 31201-2805
(478) 743-4666
(478) 743-4740
Mailing address
PO BOX 956, MACON, GA 31202-0956
(478) 743-4666
(478) 743-4740
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
03413
GA
Other
Enumeration date
07/07/2006
Last updated
07/08/2007
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