Individual
MR. HENRY DUDLEY ELLINGTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
1701 E THOMAS RD, SUITE A-104, PHOENIX, AZ 85016-7646
(888) 381-4858
Mailing address
1701 E THOMAS RD, SUITE A-104, PHOENIX, AZ 85016-7646
(888) 381-4858
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5574
AZ
363A00000X
Physician Assistant
AMD-132
HI
Other
Enumeration date
12/06/2005
Last updated
10/17/2013
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