Ellingwood, Kenneth E

Ellingwood, Kenneth E is an individual health care provider with primary practice located at 3719 Dauphin St Suite 100, Mobile AL 36608-1753. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ellingwood, Kenneth E can be contacted via phone (251) 414-5665.

Contact Information

Primary practice address
3719 Dauphin St Suite 100 Mobile AL 36608-1753
Phone: (251) 414-5665
Fax: (251) 414-5571
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 00008683 Alabama

Profile Details

NPI number 1134111537
LBN Legal business name Ellingwood, Kenneth E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Apr 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134111537 NPPES
Alabama MEDICAID 000014586
Alabama Other 1134111537
Alabama Other 920002054

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