Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. CARL EDWARD ELLIS JR.
Active Sole ProprietorMR. CARL EDWARD ELLIS JR. is a Mental Health Clinic healthcare provider located in FORT OGLETHORPE, Georgia. NPI 1376667105 is currently active in the NPPES registry. Verify at CMS.
Mental Health Clinic · FORT OGLETHORPE, GA
Registration Details
- NPI Number
- 1376667105
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 19, 2007 (19.437041593132 yrs)
- Last Updated
- Jul 8, 2007
- License
-
RPH009402 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
700 CITY HALL DRFORT OGLETHORPE, GA, 307427802Browse GA providers · Browse ZIP 30742
- Phone
- 7068613387
- Fax
- 7068613332
- Primary Specialty
-
Mental Health Clinic
261QM0801X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.