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Dr. Jason Mark Ellwood, DO
General Practice Physician in Kailua, Hawaii
NPI 1265906721

Jason Mark Ellwood is a General Practice Physician based in Kailua, HI. Jason Mark Ellwood practices in Kailua, HI and has the professional credentials of DO. The NPI Number for Jason Mark Ellwood is 1265906721 and holds a License No. 0102206240 (Hawaii).

The current practice location address for Jason Mark Ellwood is 6905 Harris Avenue, Kailua, HI and can be reached out via phone at 850-505-6601.

Location: 6905 Harris Avenue, Kailua, HI, 96734
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265906721
Provider Name
Jason Mark Ellwood
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
6905 Harris Avenue, Kailua, HI, 96734
Phone Number
850-505-6601
Fax Number
Provider Enumeration Date
01/17/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6905 Harris Avenue
City
Kailua
State
Hawaii
Zip
96734
Phone Number
850-505-6601
Fax Number
person
Provider Business Mailing Address Details
Address
6905 Harris Avenue
City
Kailua
State
Hawaii
Zip
96734
Phone Number
850-505-6601
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
0102206240 (Virginia)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
0102206240 (Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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