Ellsworth, Carolyn Ann
Ellsworth, Carolyn Ann is an individual health care provider with primary practice located at 312 N Kentucky St , West Plains MO 65775-2073. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Ellsworth, Carolyn Ann can be contacted via phone (417) 257-7076.Contact Information
Primary practice address
312 N Kentucky St
West Plains MO 65775-2073
Phone: (417) 257-7076
Fax: (417) 257-1417
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 102421 | Missouri |
Profile Details
| NPI number | 1679570618 |
|---|---|
| LBN Legal business name | Ellsworth, Carolyn Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2005 |
| Last updated | Nov 1st, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679570618 | NPPES |
| Alaska | MEDICAID | 123942001 | |
| Alaska | MEDICAID | 203592001 |
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