Individual
DR. JAMES K ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
608 N ACADIA RD, THIBODAUX, LA 70301-4847
(985) 449-4642
(985) 449-2560
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 449-4642
(985) 449-2560
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
021233
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932205
—
LA
01
—
721245423
UNITED HEALTHCARE
LA
Enumeration date
10/10/2006
Last updated
02/01/2017
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