NPI 1104010206

Richard Leroy Ellis, MD

Practitioner General Practice Physician Birmingham, AL

Practice location

Address: 2657 Park Lane CT East--Unit F, Birmingham, AL 35223
Phone: (205) 879-1386

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence DO145 (AL)

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Registry record

NPI: 1104010206
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Aug 2007
Record last updated: 31 Aug 2007

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.