# MEDSTREAM PAIN SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316389489
- **Authorized official:** KENNETH R ELLINGTON MD (PRESIDENT)
- **Authorized official phone:** (828) 210-9386

## Contact information

- **Practice address:** 615 RIDGE RD, ROXBORO, NC 27573-4629
- **Practice address phone:** (336) 503-5691
- **Mailing address:** 82 PATTON AVE, SUITE 510, ASHEVILLE, NC 28801-3319
- **Mailing address phone:** (828) 210-9386
- **Mailing address fax:** (828) 210-9388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/18/2013
- **Last updated:** 07/18/2013