Organization
CAROLINA ANESTHESIA GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH RAYNOR ELLINGTON MD (PRESIDENT)
(864) 576-2073
Entity
Organization
Contact information
Practice address
830 ROCKFORD ST, MOUNT AIRY, NC 27030-5322
(336) 719-7000
(828) 398-5223
Mailing address
PO BOX 2297, ASHEVILLE, NC 28802-2297
(828) 210-9386
(828) 210-9388
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Enumeration date
03/17/2009
Last updated
09/05/2013
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