Individual provider · Type 1 NPI

Gary D. Ellis

Student in an Organized Health Care Education/Training Program · Dayton, OH

NPI number 1497189203 Active

Practice location

4881 Sugar Maple Dr, 88MDG/MDOS/SGOW Wright Patterson Afb
Dayton, OH 45433-5529

Call (937) 257-6876 Map

Mailing address

2489 Edgewater Dr, Unit 2
Beavercreek, OH 45431-5644

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1497189203

Gary D. Ellis's National Provider Identifier is 1497189203, issued on Aug 28, 2013. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Dayton, OH. The record was last updated on Aug 28, 2013.