DR. Russell John Ellicott, D.P.M.

NPI #1720022452 in Martinez, Georgia

Provider Information

NPI Number: 1720022452
Entity Type: Individual
Name: DR. Russell John Ellicott, D.P.M.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Podiatrist
Credential: D.P.M.
Enumeration Date: Jun 15, 2006
Last Updated: Feb 6, 2019

Practice Location

Address: 501 FURYS FERRY RD
City: Martinez
State: Georgia
ZIP Code: 30907-9059
Phone: (706) 738-3298

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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