Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ezra Daniel Ellis, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1164602611

Dr. Ezra Daniel Ellis, MD is a Pathology in Gainesville, Georgia. Qualified in 2003, 23 years ago. Practices with Gainesville Regional Pathology Associates, PC, an 8-clinician group and accepts Medicare assignment. Licensed in Georgia, Idaho and North Carolina.

Years since qualifying
23
Licensed in
GA, ID, NC
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

743 Spring St NE
Gainesville, GA 30501-3715
Phone: (770) 219-1136
Fax: (770) 219-6204
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 70094 (GA)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence M-10161 (ID)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence 2007-00176 (NC)

Record details

NPI number1164602611
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 13, 2007
Last updated in NPPESOctober 28, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Gainesville Regional Pathology Associates, Pc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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