| Jack Ellis I, PA-C | |
| 
					4141 N Hampton Dr Ste 200, Powell, OH 43065-7062  | |
| (614) 764-0200 | |
| Not Available | 
| Full Name | Jack Ellis I | 
|---|---|
| Gender | Male | 
| Speciality | Physician Assistant | 
| Location | 4141 N Hampton Dr Ste 200, Powell, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1346962982 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363A00000X | Physician Assistant | 50.007768RX (Ohio) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jack Ellis I, PA-C Po Box 7527, Dublin, OH 43017-0727 Ph: () -  | Jack Ellis I, PA-C 4141 N Hampton Dr Ste 200, Powell, OH 43065-7062 Ph: (614) 764-0200  | 
Kimberly Smith,  Physician Assistant Medicare: Medicare Enrolled Practice Location: 120 E Olentangy St, Powell, OH 43065 Phone: 614-898-1211 Fax: 614-961-1096  | |
Ashley Suffoletto,  Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10330 Sawmill Pkwy, Suite 300, Powell, OH 43065 Phone: 614-794-0481 Fax: 614-794-3711  | |
Madison Mackenzie Rapier, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 507 Vogt Ct S, Powell, OH 43065 Phone: 614-800-2721  | |
Sujithra Reprakash, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 70 Clairedan Dr, Powell, OH 43065 Phone: 614-533-6850 Fax: 614-781-1434  |