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Individual

DR. THELLIE RUPERT AINSLEY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-2164
(910) 715-4493
Mailing address
PO BOX 8500, PINEHURST, NC 28374-8500
(910) 715-1010
(910) 715-1026

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25545
NC
208M00000X
Hospitalist Physician
Primary
25545
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110199352
PALMETTO GBA RAILROAD MEDICARE
NC
05
8910451
NC
Enumeration date
04/03/2007
Last updated
04/16/2013
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