Organization
HATTIESBURG ANESTHESIA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH RAYNOR ELLINGTON MD (PRESIDENT)
(864) 591-1540
Entity
Organization
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 268-8000
Mailing address
158 W MAIN ST, SPARTANBURG, SC 29306-2333
(864) 591-1540
(864) 591-1455
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/09/2007
Last updated
08/22/2020
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