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

Mark I Ellen, MD

Individual provider Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1720181951

Mark I Ellen, MD is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Atlanta, Georgia. Practices as a sole proprietor. Licensed in California, Florida, Georgia and North Carolina and 2 more.

Licensed in
CA, FL, GA, NC, NJ, PA
In the registry since
2006
Specialties on file
7
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

2108 Alexander Cir NE
Atlanta, GA 30326-1246
Phone: (214) 952-3501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence ME145025 (FL)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence 25MA06361300 (NJ)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence MD051555L (PA)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence 2005-01826 (NC)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence G71376 (CA)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence ME145025 (FL)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence 50578 (GA)

Record details

NPI number1720181951
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 6, 2006
Last updated in NPPESMay 18, 2020
Certification dateMay 18, 2020
Mailing address10435 Se 170th Pl, Summerfield, FL 34491-8998

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