Richard Alan Ellis M.d,

NPI #1033412846 in Germantown, Tennessee

Provider Information

NPI Number: 1033412846
Entity Type: Organization
Organization Name: Richard Alan Ellis M.d,
Primary Specialty: Surgery
Enumeration Date: Dec 16, 2010
Last Updated: Jan 16, 2013

Practice Location

Address: 3066 FOUNTAINSIDE DR STE 102
City: Germantown
State: Tennessee
ZIP Code: 38138-7820
Phone: (901) 755-7335

Authorized Official

Name: DONICA WOODS ELLIS, RN
Title: PRACTICE ADMINISTRATOR
Phone: (901) 755-7069

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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