Provider Demographics
NPI:1649304114
Name:ELLIS, MARGARET P (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:P
Last Name:ELLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:918-787-1909
Mailing Address - Fax:918-787-3866
Practice Address - Street 1:10 E 13TH ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-5300
Practice Address - Country:US
Practice Address - Phone:918-787-1909
Practice Address - Fax:918-787-3866
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1953207R00000X
OK20200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARG48991Medicare UPIN
AR5K976Medicare UPIN