Individual
DR. MARK ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5880 S HOSPITAL DR, GLOBE, AZ 85501-9447
(928) 425-3246
Mailing address
5994 S HOSPITAL DR, GLOBE, AZ 85501-9462
Taxonomy
Speciality
Code
Description
License number
State
213EP0504X
Public Medicine Podiatrist
10105797-0501
UT
213ER0200X
Radiology Podiatrist
10105797-0501
UT
213ES0000X
Sports Medicine Podiatrist
10105797-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0821
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
10105797-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367438
—
AZ
Enumeration date
06/06/2011
Last updated
06/10/2025
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