Individual
DR. ELLEN A KINGSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
36 LIVELY OAKS ROAD, LIVELY, VA 22507
(804) 462-5155
(804) 462-5922
Mailing address
PO BOX 2255, KILMARNOCK, VA 22482-2255
(804) 462-5155
(804) 462-5922
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101051241
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080108568
RR MEDICARE
VA
01
—
323363
ANTHEM BCBS
VA
Enumeration date
07/20/2006
Last updated
11/20/2009
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