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Kenneth E Ellingwood, MD
Specialist in Mobile, Alabama
NPI 1134111537

Kenneth E Ellingwood is a Specialist based in Mobile, AL. Kenneth E Ellingwood practices in Mobile, AL and has the professional credentials of MD. The NPI Number for Kenneth E Ellingwood is 1134111537 and holds a License No. 00008683 (Alabama).

The current practice location address for Kenneth E Ellingwood is 3719 Dauphin St, Mobile, AL and can be reached out via phone at 251-414-5665 and via fax at 251-414-5571.

Location: 3719 Dauphin St, Mobile, AL, 36608-1753
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134111537
Provider Name
Kenneth E Ellingwood
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3719 Dauphin St, Mobile, AL, 36608-1753
Phone Number
251-414-5665
Fax Number
251-414-5571
Provider Enumeration Date
08/22/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000014586 05 AL
1134111537 01 NPI
920002054 01 AL RR MEDICARE
institution
Provider Business Practice Location Address Details
Address
3719 Dauphin St
City
Mobile
State
Alabama
Zip
36608-1753
Phone Number
251-414-5665
Fax Number
251-414-5571
person
Provider Business Mailing Address Details
Address
3719 Dauphin St
City
Mobile
State
Alabama
Zip
36608-1753
Phone Number
251-414-5665
Fax Number
251-414-5571
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
00008683 (Alabama)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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