Jerry H Ellis OD

NPI 1083776611 - Optometrist - 152W00000X

NPI Details
NPI 1083776611
Gender Male
Enumeration Date 12/13/2006
Last Updated 12/07/2009
Entity Type Individual
Active Over 9 years ago
Practice Location
197 HOSPITAL DRIVE
SUITE A
CHEROKEE VILLAGE AR, 72529-7315, US
Phone (870) 257-2100
Fax (870) 257-4395
Business Location
197 HOSPITAL DRIVE
SUITE A
CHEROKEE VILLAGE AR, 72529-7315, US
Phone (870) 257-2100
Fax (870) 257-4395
Toxanomy
Taxonomy Code 152W00000X
License State Arkansas
License Number 2408
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According to our database, Dr. Jerry H Ellis OD NPI is 1083776611, taxonomy code is 152W00000X and license number is 2408, license state is located at Arkansas. Jerry H Ellis OD physically located at 197 Hospital Drive, Cherokee Village AR, 72529-7315. NPI Number Jerry H Ellis OD has the Individual type.

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1083776611 NPI number is provided on an as is basis without warranty of any kind. 1083776611 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry H Ellis OD are for informational purposes only.