Adam W Ellis (NPI# 1003918731, PAC ID# 8224068028) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1003918731 |
| PAC ID by PECOS | 8224068028 |
| Professional Enrollment ID | I20061030000060 |
| Full Name | Adam W Ellis |
| Organization Legal Name | LOGAN PHYSICIAN PRACTICE LLC |
| Address |
128 Sugar Maple Dr Auburn KY 42206-5352 |
| Phone Number | 2705425500 |
| Gender | M |
| Credential | MD |
| Medical School | MOUNT SINAI SCHOOL OF MEDICINE OF CITY UNIVERSITY OF NEW YORK |
| Graduation Year | 1994 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 4880596592 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180066 | LOGAN MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 128 Sugar Maple Dr, Auburn, KY 42206-5352 | 2705425500 | LOGAN PHYSICIAN PRACTICE LLC |
| 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 | 2707268090 | LOGAN PHYSICIAN PRACTICE LLC |
| Organization Legal Name | LOGAN PHYSICIAN PRACTICE LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James C Dodson | Internal Medicine | Logan Physician Practice LLC | 147 E 5th St, Russellville, KY 42276-1903 |
| Cynthia Jo Bond | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Blair R Mendoza | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Gillian J Stuart | General Surgery | Logan Physician Practice LLC | 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 |
| Charles H Mathis | Family Medicine | Logan Physician Practice LLC | 975 Hopkinsville Rd, Russellville, KY 42276-9774 |
| Stephanie Diane Geraci | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Steve G Salyers | Orthopedic Surgery | Logan Physician Practice LLC | 1623 Nashville St, Suite 106, Russellville, KY 42276-8889 |
| Cynthia J Finley | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Trisha K Campbell | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Street Address |
128 SUGAR MAPLE DR |
| City | AUBURN |
| State | KY |
| Zip | 42206-5352 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia Jo Bond | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Blair R Mendoza | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Stephanie Diane Geraci | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Cynthia J Finley | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Trisha K Campbell | Nurse Practitioner | Logan Physician Practice LLC | 128 Sugar Maple Dr, Auburn, KY 42206-5352 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James M Staples | Nurse Practitioner | Staples Health Clinic LLC | 104 E Main St, Auburn, KY 42206-5106 |
| Stacia A Staples | Nurse Practitioner | Staples Health Clinic LLC | 104 E Main St, Auburn, KY 42206-5106 |
| City | AUBURN |
| Zip Code | 42206 |
| Specialty | GENERAL SURGERY |
| City + Specialty | AUBURN + GENERAL SURGERY |
Please comment or provide details below to improve the information on Adam W Ellis.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.