Matthew Mckinley Ellsworth
Podiatrist Foot Surgery
613 23rd St Ste G30
Ashland
, Kentucky 41101-2881
Matthew Mckinley Ellsworth
Podiatrist Foot Surgery
613 23rd St Ste G30
Ashland
, Kentucky 41101-2881
(606) 408-6612
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About
Features
Specialties
- Podiatrist
- Foot Surgery
Languages spoken
- English
Location
First Address
- Matthew Mckinley Ellsworth
- Po Box 2379
- Ashland, KY
- Zip : 41105-2379
- Fax : (606) 408-6612
- Phone : (606) 408-6200
Second Address
- Matthew Mckinley Ellsworth
- 613 23rd St Ste G30
- Ashland, KY
- Zip : 41101-2881
- Fax : (606) 326-1159
- Phone : (606) 327-0036
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 00426 | KY |
| Y | 222Z00000X | Podiatrist | 00426 | KY |
| N | 213E00000X | Podiatrist | 36.003921 | OH |
| N | 222Z00000X | Podiatrist | 36.003921 | OH |
| N | 213ES0131X | Foot Surgery | 00426 | KY |
National Provider Identifier
| NPI | 1124387618 |
|---|---|
| Provider Name | Matthew Mckinley Ellsworth |
| First Address | Ashland, KY 41105-2379 |
| Second Address | Ashland, KY 41101-2881 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2012 |
| Last Update Date | 12/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 7100351750 | (05) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.