Provider Demographics
NPI:1801091996
Name:EZZELL, ERIN ELAINE (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELAINE
Last Name:EZZELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 S MOUNT AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6387
Mailing Address - Country:US
Mailing Address - Phone:573-519-4800
Mailing Address - Fax:
Practice Address - Street 1:800 NE 10TH ST FL 6
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5418
Practice Address - Country:US
Practice Address - Phone:405-271-4022
Practice Address - Fax:405-271-3020
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009002510207RH0003X, 207R00000X
OK8800207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine