Organization · Type 2 NPI

Jeri L Ellis Md, Mph, PC

Primary Care Clinic/Center · Shawnee, OK

NPI number 1538672001 Active

Practice location

420 N Kickapoo Ave
Shawnee, OK 74801-6643

Call (400) 581-6331 Map

Mailing address

5909 NW Expressway Ste 360
Oklahoma City, OK 73132-5149

Specialties and licenses

TaxonomyCodeLicense
Adult Medicine Physician 207QA0505XNone listed
Primary Care Clinic/Center Primary 261QP2300XNone listed

Primary Care Clinic/Center: Definition to come...

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About NPI 1538672001

Jeri L Ellis Md, Mph, PC's National Provider Identifier is 1538672001, issued on Nov 7, 2017. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Shawnee, OK. The record was last updated on Nov 7, 2017.