Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. ELLIS RAY TACKETT III, ATC LAT
ActiveMR. ELLIS RAY TACKETT III, ATC LAT is a Specialist healthcare provider located in PIKEVILLE, Kentucky. NPI 1821489576 is currently active in the NPPES registry. Verify at CMS.
Specialist · PIKEVILLE, KY
Registration Details
- NPI Number
- 1821489576
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 16, 2015 (11.450451656183 yrs)
- Last Updated
- Feb 16, 2015
- License
-
AT1092 (KY)
Practice Information
- Address
-
147 SYCAMORE STPIKEVILLE, KY, 415019118Browse KY providers · Browse ZIP 41501
- Phone
- 6062131620
- Fax
- 6062185353
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in PIKEVILLE, KY
| Name | Credential | NPI |
|---|---|---|
| OSCAR W THOMPSON III | MD | 1588656078 |
| DR. BRAHMAJI S. PURAM | MD | 1174537450 |
| MRS. CELIA B. HALL | — | 1467645846 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.