Healthcare Provider Details

I. General information

NPI: 1114365749
Provider Name (Legal Business Name): ELLEN LEIGH HEARTY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN LEIGH MARTINO MD

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 01/28/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 HENDERSONVILLE RD
ASHEVILLE NC
28803-2868
US

IV. Provider business mailing address

119 HENDERSONVILLE RD
ASHEVILLE NC
28803-2868
US

V. Phone/Fax

Practice location:
  • Phone: 828-771-5537
  • Fax:
Mailing address:
  • Phone: 828-771-5537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2014-01758
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: