Jared Scott Ellsworth, PA

NPI #1821829821 in Ardmore, Oklahoma

Provider Information

NPI Number: 1821829821
Entity Type: Individual
Name: Jared Scott Ellsworth, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Aug 12, 2024
Last Updated: Aug 12, 2024

Practice Location

Address: 1104 WALNUT DR
City: Ardmore
State: Oklahoma
ZIP Code: 73401-2353
Phone: (580) 223-3411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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