Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RUSSELL JOHN ELLICOTT, D.P.M.
Active Sole ProprietorDR. RUSSELL JOHN ELLICOTT, D.P.M. is a Podiatrist healthcare provider located in MARTINEZ, Georgia. NPI 1720022452 is currently active in the NPPES registry. Verify at CMS.
Podiatrist · MARTINEZ, GA
Registration Details
- NPI Number
- 1720022452
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 15, 2006 (20.192848888097 yrs)
- Last Updated
- Feb 6, 2019
- Licenses
-
96 (SC)POD000558 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
501 FURYS FERRY RDMARTINEZ, GA, 309079059Browse GA providers · Browse ZIP 30907
- Phone
- 7067383298
- Fax
- 7063644290
- Primary Specialty
-
Podiatrist
213E00000X
- Additional Specialty
- Podiatrist
Other Podiatrist Providers in MARTINEZ, GA
| Name | Credential | NPI |
|---|---|---|
| JANAKI NADARAJAH | DPM | 1831288018 |
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.