Individual
DR. KATHLEEN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8316 ARLINGTON BLVD STE 400, FAIRFAX, VA 22031-5216
(703) 641-0083
(703) 641-0085
Mailing address
5310 HARVEST HILL RD STE 290, DALLAS, TX 75230-5826
(214) 420-0650
(214) 736-0512
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101267527
VA
Other
Enumeration date
04/15/2015
Last updated
10/09/2019
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