Dr SHANNON ELLIS is a male medical professional, specializing in Preventative Medicine. He graduated in 2003 from Lake Erie College Of Osteopathic Medicine.
APPLECARE LLC
111 COLONIAL WAY
JESUP
GA
315450130
Tel: 9125889110
| Npi | 1295706166 |
| Pac Id | 7113116070 |
| Professional Enrollment Id | I20110106001192 |
| Last Name | ELLIS |
| First Name | SHANNON |
| Middle Name | |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | PREVENTATIVE MEDICINE |
| Secondary Specialty 1 | |
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| Organization Legal Name | APPLECARE LLC |
| Group Practice Pac Id | 5991778573 |
| Number Of Group Practice Members | 51 |
| Line 1 Street Address | 111 COLONIAL WAY |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | JESUP |
| State | GA |
| Zip Code | 315450130 |
| Phone Number | 9125889110 |
| Hospital Affiliation Ccn 1 | 110124 |
| Hospital Affiliation Lbn 1 | WAYNE MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 2 | |
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| Professional Accepts Medicare Assignment | Y |
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