NPI age
18 years
Enumerated 2007-11-13
● Active
Type 1 · Individual
DR. Ezra Daniel Ellis, M.D.
Ellis is 1 of 12 pathology providers in Gainesville and 1 of 483 in Georgia.
Primary specialty
Pathology
Plus 2 subspecialties
Licensed in
GA, ID, NC
3 states
Status
Active
No deactivations on record
Last NPPES update
2019-10-28
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 483 active pathology providers in Georgia.
NPI age
18 years
≈ at median (19 yr)
State licenses
3 states
Top 85% — 14% of peers are multi-state
Subspecialties
0
31% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-11Enumerated in NPPES
2007
2026
Where they practice
Practice location
743 Spring St Ne
Gainesville, GA 305013715
Mailing address
Po Box 3293
Indianapolis, IN 462063293
Specialties
-
Pathology PrimaryA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010167581 | REGENCE BLUESHIELD OF IDAHO |
| 01 (ID) | 77342 | BLUECROSS OF IDAHO |
| 05 (ID) | 808087600 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 689 other active providers share this practice address in NPPES.
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