Ellsworth, Matthew Mckinley

Ellsworth, Matthew Mckinley is an individual health care provider with primary practice located at 613 23Rd St Ste G30 , Ashland KY 41101-2881. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Ellsworth, Matthew Mckinley can be contacted via phone (606) 327-0036.

Contact Information

Primary practice address
613 23Rd St Ste G30 Ashland KY 41101-2881
Phone: (606) 327-0036
Fax: (606) 326-1159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 36.003921 Ohio
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 00426 Kentucky
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00426 Kentucky

Profile Details

NPI number 1124387618
LBN Legal business name Ellsworth, Matthew Mckinley
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2012
Last updated Aug 12th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124387618 NPPES
Kentucky MEDICAID 7100351750

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