Individual provider · NPI-1
Dr. Miles Wayne Ellis, MD
Emergency Medicine · Phenix City, AL
NPI number1871510644
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1871510644
- Entity type
- Individual (NPI-1)
- Name
- Dr. Miles Wayne Ellis
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 16, 2006
- Certification date
- Sep 11, 2025
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 27642 | AL | Yes |
| 207Q00000X | Family Medicine | 039782 | GA |
Practice location
4401 River Chase DrEmergency Dept.
Phenix City, AL 36867-7483
Phone 334-732-3000 · Fax 334-732-3020
Mailing address
1705 Crest DrColumbus, GA 31906-3507
Phone 706-324-4065
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