NPI 1063013613

John Ellis

Practitioner Pharmacist Newnan, GA

Practice location

Address: 135 Rudders Xing, Newnan, GA 30263-7032
Phone: (678) 994-2192

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence RPH024504 (GA)

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Registry record

NPI: 1063013613
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Nov 2020
Record last updated: 2 Nov 2020

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.