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DR. MARK FREDERICK ELLISON M.D.
NPI 1265431092
Urology in Athens, GA

Active since July 14, 2005
2142 W BROAD ST, BUILDING 200, SUITE 200, ATHENS, GA 30606(706) 612-9401(706) 612-9410 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Mark Frederick Ellison M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK FREDERICK ELLISON M.D. (NPI 1265431092) is an individual urology provider in Athens, Georgia, licensed in Georgia (026107) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1265431092
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameDR. MARK FREDERICK ELLISONCredential: M.D.
Location Address2142 W BROAD ST, BUILDING 200, SUITE 200Athens, GA 30606-3506
Mailing AddressPo Box 6127Athens, GA 30604-6127 · (706) 612-9401 · Fax (706) 612-9410
Phone(706) 612-9401
Fax(706) 612-9410
Sole ProprietorNo
Enumeration DateJuly 14, 2005
Last NPPES UpdateMarch 7, 2023
✔ NPI 1265431092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in GA · 026107
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2142 W BROAD ST, Athens, GA 30606
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Other Identifiers 1

Medicaid000370994FGA

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GNS,LLC
Neurological Surgery
2142 W BROAD ST, BLDG 100 SUITE 200
ATHENS, GA 30606
Clarke County (706) 548-6881
MRS. DONNA BAGGETT MARTIN FNP-BC
Nurse Practitioner (Family)
2142 W BROAD ST, BLDG 100, STE 200
ATHENS, GA 30606
Clarke County (706) 548-6881
BOGDAN CRISTIAN JALIU MD
Physical Medicine & Rehabilitation (Pain Medicine)
2142 W BROAD ST, BLDG 100 STE 200
ATHENS, GA 30606
Clarke County (706) 548-6881
HARLAN JASON BRUNER M.D.
Neurological Surgery
2142 W BROAD ST, BUILDING 100, STE 200
ATHENS, GA 30606
Clarke County (706) 548-6881
SURGERY CENTER OF ATHENS LLC
Clinic/Center (Ambulatory Surgical)
2142 W BROAD ST, SUITE 100
ATHENS, GA 30606
Clarke County (781) 733-2235
JAIME BARRERA FNP-C
Nurse Practitioner (Family)
2142 W BROAD ST, BLDG 200 STE 200
ATHENS, GA 30606
Clarke County (706) 612-9401
KAISER PERMANENTE
Clinical Medical Laboratory
2142 W BROAD ST, BLDG 200
ATHENS, GA 30606
Clarke County (706) 583-5000
MS. RACHEL VICTORIA TREADWELL FNP-C
Nurse Practitioner (Family)
2142 W BROAD ST
ATHENS, GA 30606
Clarke County (706) 612-9401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Ellison's NPI number?

The NPI number for Mark Ellison is 1265431092. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Where is Mark Ellison located?

Mark Ellison practices at 2142 W Broad St Building 200, Suite 200, Athens, GA 30606. The listed phone number is (706) 612-9401.

What is Mark Ellison's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

When was this NPI record last updated?

The NPPES record for Mark Ellison was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.