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Contact Information

KEVIN R ELLSWORTH, MD
3420 S MERCY RD STE 205
GILBERT, AZ85297-0423
 Phone: 602-933-6345
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neonatal-Perinatal Medicine

2080N0001X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KEVIN R ELLSWORTH · (Male)

NPI # 1255607263
Status Active
Credentials MD
Entity Individual
Enumeration date 03/25/2012
Last updated 12/09/2020 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 56178
Hospital affiliation(s) Not Available
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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