Robert G Ellison Jr MD P a

NPI #1699979203 in Jacksonville, Florida

Provider Information

NPI Number: 1699979203
Entity Type: Organization
Organization Name: Robert G Ellison Jr MD P a
Primary Specialty: Specialist
Enumeration Date: Jun 14, 2007
Last Updated: Aug 10, 2007

Practice Location

Address: 836 PRUDENTIAL DR
Address 2: SUITE 1405
City: Jacksonville
State: Florida
ZIP Code: 32207-8334
Phone: (904) 388-7521

Authorized Official

Name: DR. ROBERT G ELLISON JR., MD
Title: OWNER
Phone: (904) 388-7521

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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