Ellis, Paul D

Ellis, Paul D is an individual health care provider with primary practice located at 130 W Ravine Rd , Kingsport TN 37660. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Ellis, Paul D can be contacted via phone (423) 968-1144.

Contact Information

Primary practice address
130 W Ravine Rd Kingsport TN 37660
Phone: (423) 968-1144
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME103342 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 39706 Kentucky
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 40098 Tennessee

Profile Details

NPI number 1528025673
LBN Legal business name Ellis, Paul D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Nov 14th, 2018 - about 8 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 1528025673 NPPES
Tennessee Other P00278836 RAILROAD MEDICARE
Tennessee MEDICAID 3336612 RAILROAD MEDICARE

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