Individual
HILARY KATE ELLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3188 S LIZELLA RD, LIZELLA, GA 31052-4123
(478) 988-1865
(478) 988-1869
Mailing address
3188 S LIZELLA RD, LIZELLA, GA 31052-4123
(478) 988-1865
(478) 988-1869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
034822
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00495019B
—
GA
Enumeration date
09/14/2006
Last updated
07/08/2007
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