Individual
TRUITT C ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
43311
TN
207L00000X
Anesthesiology Physician
24148
AL
207L00000X
Anesthesiology Physician
Primary
43311
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009972735
—
AL
05
—
009972745
—
AL
05
—
009972755
—
AL
01
—
051525265
BLUE CROSS
AL
01
—
051525268
BLUE CROSS
AL
01
—
051525270
BLUE CROSS
AL
01
—
051531876
BLUE CROSS
AL
05
—
08526719
—
MS
05
—
3001384
—
TN
01
—
4169205
BCBS
TN
05
—
7100041490
—
KY
Enumeration date
06/15/2006
Last updated
08/05/2009
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