NPI 1033454699

Jeffrey Christian Ellis, PAC

Practitioner Physician Assistant Springfield, MO

Practice location

Address: 2150 W Republic Rd STE 112, Springfield, MO 65807-6056
Phone: (417) 986-1291

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2022006238 (MO)

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Registry record

NPI: 1033454699
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Dec 2012
Record last updated: 23 Feb 2022

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.