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General NPI Number Information
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NPI Number | 1144244112
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Entity Type | Individual
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Provider Name | KENNETH RAYNOR ELLINGTON MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 76 PEACHTREE RD STE 300
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City | ASHEVILLE
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State | NC
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Zip | 28803-3505
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Country | US
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Telephone | 828-398-5244
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Fax | 828-398-5223
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Provider Business Mailing Address
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Address Line | 76 PEACHTREE RD STE 300
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City | ASHEVILLE
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State | NC
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Zip | 28803-3505
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Country | US
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Telephone | 828-398-5244
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Fax | 828-398-5223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 38935
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License Number State | NC
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