Individual provider · NPI-1

Dr. Parker Lee Ellison Jr., MD

Internal Medicine, Gastroenterology · Flowood, MS

NPI number1760911598
StatusActive
Last updated in NPPESFeb 27, 2025

Details

NPI
1760911598
Entity type
Individual (NPI-1)
Name
Dr. Parker Lee Ellison Jr.
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 6, 2017
Certification date
Feb 27, 2025
Last updated
Feb 27, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RG0100X Internal Medicine, Gastroenterology31210MSYes
207R00000X Internal MedicineLL51144SC
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

2510 Lakeland Dr
Flowood, MS 39232-9513

Phone 601-355-1234

Mailing address

2510 Lakeland Dr
Flowood, MS 39232-9513

Other practice locations

4245 N Honeysuckle Ln
Jackson, MS 39211-6166

Phone 843-408-3882

971 Lakeland Dr Ste 250
Jackson, MS 39216-4620

Phone 601-200-2000

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