| Doctor Name: | DR. PANAYIOTIS A ELLINAS |
| NPI Number: | 1154322741 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD, MPH |
| License Number: | 23114 |
| Business Practice Address: | 100 E 5th St Cqch Billing Dept Douglas, AZ - 856072859 |
| Business Phone Number: | 5203647659 |
| Business Fax Number: | |
| Mailing Address: | 101 Cole Ave, Cqch Billing Dept BISBEE |
| State: | AZ |
| Postal Code: | 856031327 |
| Phone Number: | 5204326452 |
| Fax Number: | 5204328018 |
| NPI Enumeration Date: | 08/03/2005 |
| NPI Last Update Date: | 07/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 23114 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |