Dr. Mark Ellis
Radiology Sports Medicine Public Medicine Foot & Ankle Surgery and 1 more
12592 S 150 E
Draper
, Utah 84020-8611
Dr. Mark Ellis
Radiology Sports Medicine Public Medicine Foot & Ankle Surgery and 1 more
12592 S 150 E
Draper
, Utah 84020-8611
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About
Features
Specialties
- Public Medicine
- Radiology
- Sports Medicine
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Dr. Mark Ellis
- 5994 S Hospital Dr
- Globe, AZ
- Zip : 85501-9462
- Phone :
Second Address
- Dr. Mark Ellis
- 12592 S 150 E
- Draper, UT
- Zip : 84020-8611
- Phone : (713) 377-2167
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213EP0504X | Public Medicine | 10105797-0501 | UT |
| N | 111NR0200X | Radiology | 10105797-0501 | UT |
| N | 213ER0200X | Radiology | 10105797-0501 | UT |
| N | 2081S0010X | Sports Medicine | 10105797-0501 | UT |
| N | 213ES0000X | Sports Medicine | 10105797-0501 | UT |
| Y | 213ES0103X | Foot & Ankle Surgery | 0821 | AZ |
| N | 213ES0103X | Foot & Ankle Surgery | 10105797-0501 | UT |
National Provider Identifier
| NPI | 1972897080 |
|---|---|
| Provider Name | Dr. Mark Ellis |
| First Address | Globe, AZ 85501-9462 |
| Second Address | Draper, UT 84020-8611 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/06/2011 |
| Last Update Date | 17/05/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.