Individual provider · Type 1 NPI

Jacob Ellis, PA-C

Vascular Surgery Physician · Colorado Springs, CO

NPI number 1407730765 Active

Practice location

7808 Ultra Dr
Colorado Springs, CO 80920-8058

Call (719) 209-5569 Map

Specialties and licenses

TaxonomyCodeLicense
Vascular Surgery Physician Primary 2086S0129X1234 (CO)

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 1407730765

Jacob Ellis, PA-C's National Provider Identifier is 1407730765, issued on Jul 31, 2025. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Colorado Springs, CO. The record was last updated on Jul 31, 2025.