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Contact Information

PAUL D ELLIS, MD
130 W RAVINE RD
KINGSPORT, TN37660
 Phone: 423-968-1144
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for PAUL D ELLIS · (Male)

NPI # 1528025673
Status Active
Credentials MD
Entity Individual
Enumeration date 05/01/2006
Last updated 11/14/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME103342
  • KY License # 39706
  • TN License # 40098
  • TN Medicaid 3336612
  • TN Other P00278836 RAILROAD MEDICARE
Hospital affiliation(s)
  • TAKOMA REGIONAL HOSPITAL - (Acute Care)
    401 TAKOMA AVE
    GREENEVILLE, TN 37743
  • WELLMONT BRISTOL REGIONAL MEDICAL CENTER - (Acute Care)
    ONE MEDICAL PARK BLVD
    BRISTOL, TN 37620
  • WELLMONT HOLSTON VALLEY MEDICAL CENTER - (Acute Care)
    130 WEST RAVINE ROAD
    KINGSPORT, TN 37662
  • WELLMONT LONESOME PINE HOSPITAL - (Acute Care)
    1990 HOLTON AVENUE EAST
    BIG STONE GAP, VA 24219
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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