| Robert E Ellis Md | |
|
9115 Leesgate Rd Suite C Louisville KY 40222-5003 | |
| (502) 719-0782 | |
| (502) 719-0787 |
| Full Name | Robert E Ellis Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 9115 Leesgate Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Robert E Ellis (PRESIDENT) |
| Authorized Official Contact | 5027190782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert E Ellis Md 9115 Leesgate Rd Suite C Louisville KY 40222-5003 Ph: (502) 719-0782 | Robert E Ellis Md 9115 Leesgate Rd Suite C Louisville KY 40222-5003 Ph: (502) 719-0782 |
| NPI Number | 1154465276 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 08/13/2009 |
| Medicare PECOS PAC ID | 4880630078 |
|---|---|
| Medicare Enrollment ID | O20050628000795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154465276 | NPI | - | NPPES |
| 1172028 | Other | KY | PASSPORT HEALTH PLAN |
| 2441036000 | Other | KY | PASSPORT ADVANTAGE |
| CH0800 | Other | KY | MEDICARE RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 19194 (Kentucky) | Primary |
| Provider Name | Robert E Ellis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427006816 PECOS PAC ID: 0941246136 Enrollment ID: I20110216000073 |
Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15103 Chestnut Ridge Cir, Louisville, KY 40245 Phone: 502-742-9149 Fax: 502-896-7292 | |
Veloz Medical Services Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6911 Shepherdsville Rd, Louisville, KY 40219 Phone: 502-644-3076 | |
Kentucky Joint Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4010 Dupont Cir Ste 310, Louisville, KY 40207 Phone: 502-771-5432 Fax: 502-771-5430 | |
Edina Torlak Md, Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3950 Kresge Way Ste 302, Louisville, KY 40207 Phone: 502-893-7372 | |
Shirley J Meredith, Md, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4000 Kresge Way, Baptist East Wound Care Center, Louisville, KY 40207 Phone: 502-259-4470 Fax: 502-259-4471 | |
Sorelle Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 927 W Main St, Louisville, KY 40202 Phone: 502-208-5787 Fax: 502-690-4364 | |
Deer Park Family Doctors Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1603 Stevens Ave, Louisville, KY 40205 Phone: 502-451-5955 Fax: 502-451-5925 |