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Contact Information

ROBERT ELLIS JR, OD
425 E 10TH ST
SUITE C
ANNISTON, AL36207-4787
 Phone: 256-236-7516
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ROBERT ELLIS JR · (Male)

NPI # 1154415370
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 10/03/2006
Last updated 09/30/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • AL License # S-A50-TA-640
  • AL Medicaid 051554369
  • AL Other 051520873 BCBS ANNISTON
  • AL Other 051520874 BCBS WOODLAND
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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