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Organization

C W ELLISON MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARROL WENDALL ELLISON M.D. (OWNER)
(828) 433-5700
Entity
Organization

Contact information

Practice address
500 E PARKER RD, MORGANTON, NC 28655-5113
(828) 433-5700
(828) 433-5702
Mailing address
500 E PARKER RD, MORGANTON, NC 28655-5113
(828) 433-5700
(828) 433-5702

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
19994
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5901279
NC
Enumeration date
07/02/2006
Last updated
02/04/2013
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