Individual provider · Type 1 NPI

Jonathan J. Ellichman, MD

Vascular Surgery Physician · Memphis, TN

NPI number 1073538823 Active

Practice location

6401 Poplar Ave Ste 410
Memphis, TN 38119-4808

Call (901) 259-2718 Map

Fax (901) 259-1123

Mailing address

1779 Kirby Pkwy # 1-511
Memphis, TN 38138-3666

Specialties and licenses

TaxonomyCodeLicense
Vascular Surgery Physician Primary 2086S0129X18972 (MS)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X39618 (TN)

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

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About NPI 1073538823

Jonathan J. Ellichman, MD's National Provider Identifier is 1073538823, issued on Jul 13, 2006. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Memphis, TN. The record was last updated on Mar 8, 2016.