Individual provider · Type 1 NPI
Mark Ellis, DPM
Foot Surgery Podiatrist · Lafayette, LA
NPI number
1215975891
Active
Practice location
501 W Saint Mary Blvd, Suite B
Lafayette, LA 70506-4600
Fax (337) 593-1280
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot Surgery Podiatrist Primary | 213ES0131X | 1670511 (LA) |
Foot Surgery Podiatrist: Definition to come...
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About NPI 1215975891
Mark Ellis, DPM's National Provider Identifier is 1215975891, issued on Jun 3, 2006. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in Lafayette, LA. The record was last updated on Sep 5, 2008.