person
Kenneth Robert Ellison, PA
Medical Physician Assistant in Fort Walton Beach, Florida
NPI 1831122803

Kenneth Robert Ellison is a Medical Physician Assistant based in Fort Walton Beach, FL and is specialized in Medical. Kenneth Robert Ellison practices in Fort Walton Beach, FL and has the professional credentials of PA. The NPI Number for Kenneth Robert Ellison is 1831122803 and holds a License No. 9106823 (Florida).

The current practice location address for Kenneth Robert Ellison is 1032 Mar Walt Dr, Fort Walton Beach, FL and can be reached out via phone at 850-863-3463 and via fax at 850-315-6051.

Location: 1032 Mar Walt Dr, Fort Walton Beach, FL, 32547-6661
person
Provider Profile Details
NPI Number
1831122803
Provider Name
Kenneth Robert Ellison
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1032 Mar Walt Dr, Fort Walton Beach, FL, 32547-6661
Phone Number
850-863-3463
Fax Number
850-315-6051
Provider Enumeration Date
07/10/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1032 Mar Walt Dr
City
State
Zip
32547-6661
Phone Number
850-863-3463
Fax Number
850-315-6051
person
Provider Business Mailing Address Details
Address
1032 Mar Walt Dr
City
State
Zip
32547-6661
Phone Number
850-863-3463
Fax Number
850-315-6051
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
9106823 (Florida)
Definition
Definition to come...
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