Shannon Scott Ellis MD

NPI 1124219563 - Family Medicine - 207Q00000X

NPI Details
NPI 1124219563
Gender Male
Enumeration Date 08/08/2007
Last Updated 02/21/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
3280 HENDERSON DR STE C
JACKSONVILLE NC, 28546-5290, US
Phone (910) 219-1713
Fax (910) 219-1782
Business Location
3280 HENDERSON DR STE C
JACKSONVILLE NC, 28546-5290, US
Phone (910) 219-1713
Fax (910) 219-1782
Toxanomy
Taxonomy Code 207Q00000X
License State North Carolina
License Number 2007-01049
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According to our database, Dr. Shannon Scott Ellis MD NPI is 1124219563, taxonomy code is 207Q00000X and license number is 2007-01049, license state is located at North Carolina. Shannon Scott Ellis MD physically located at 3280 Henderson Dr Ste C, Jacksonville NC, 28546-5290. NPI Number Shannon Scott Ellis MD has the Individual type.

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1124219563 NPI number is provided on an as is basis without warranty of any kind. 1124219563 is maintained by the National Plan & Provider Enumeration System. The contents of Shannon Scott Ellis MD are for informational purposes only.