NPI 1013709336

Brandon Lee Ellis, PAC

Practitioner Physician Assistant Gainesville, GA

Practice location

Address: 1104 Elm Grove Ave, Gainesville, GA 30501-3901
Phone: (850) 450-0002

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1013709336
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 May 2025
Record last updated: 27 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.