| NPI | 1538672001 |
|---|---|
| Doing Business As | ELLIS FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DENISE CATO Contracting Manager 405-470-1884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |