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Contact Information

ELLIS I EFOBI, MD
1525 E. PARK PLACE BLVD.
SUITE 300
STONE MOUNTAIN, GA30087-3453
 Phone: 770-879-7707
 Fax: 770-879-7708
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for ELLIS I EFOBI · (Male)

NPI Number 1144487018
Status Active
Credentials MD
Entity Individual
Enumeration date 05/19/2008
Last updated 02/02/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 060727
  • GA Medicaid 594981959A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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