Organization
DR JOHN P ELLIS CLINIC PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P ELLIS DPM (PRESIDENT)
(440) 333-7300
Entity
Organization
Contact information
Practice address
21992 LORAIN RD, FAIRVIEW PARK, OH 44126-3333
(440) 333-7300
(440) 235-8440
Mailing address
4758 RIDGE RD, STE 161, CLEVELAND, OH 44144-3327
(440) 235-8484
(440) 235-8440
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002463E
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0691845
—
OH
Enumeration date
04/21/2008
Last updated
07/21/2015
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