DR. Timothy J. Ellis, O.D.

NPI #1285644856 in Boise, Idaho

Provider Information

NPI Number: 1285644856
Entity Type: Individual
Name: DR. Timothy J. Ellis, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Aug 8, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 500 W FORT ST
City: Boise
State: Idaho
ZIP Code: 83702-4501
Phone: (208) 422-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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