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Contact Information

GEORGE E ELLIS, DMD
108 TRADE CENTER LN
HAZLEHURST, MS39083-2319
 Phone: 601-894-4016
 Fax: 601-894-1751
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for GEORGE E ELLIS · (Male)

NPI # 1235347436
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 05/19/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 233687
  • MS Medicaid 00060353
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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