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Contact Information

GERALD ELLIS
10301 E STATE ROAD 37
FORT WAYNE, IN46835-9591
 Phone: 260-492-1333
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacotherapy

1835P1200X
Indicates primary specialty

NPI Profile & details for GERALD ELLIS · (Male)

NPI # 1487066676
Status Active
Credentials
Entity Individual
Enumeration date 05/22/2014
Last updated 05/22/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 26023966A
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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