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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KENNETH ROBERT ELLISON, PA

Active

KENNETH ROBERT ELLISON, PA is a Medical Physician Assistant healthcare provider located in FORT WALTON BEACH, Florida. NPI 1831122803 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · FORT WALTON BEACH, FL

Registration Details

NPI Number
1831122803
Provider Type
Individual
Gender
Male
NPI Issued
Jul 10, 2006 (20.062610274486 yrs)
Last Updated
Jan 14, 2022
License
9106823 (FL)

Practice Information

Address
1032 MAR WALT DR
SUITE 250
FORT WALTON BEACH, FL, 325476661
Browse FL providers · Browse ZIP 32547
Phone
8508633463
Fax
8503156051
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in FORT WALTON BEACH, FL

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MR. MARCOS OTERO PA-C 1336138072
MR. STEVE RANDOLPH SWITZER PA-C 1003878356
MR. GARY WILLIAM MOUSSEAU PA-C 1861593956
MICHELLE JO ADKINS PA-C 1265722920
COURTNEY MCGEE PA 1740539535
DR. CLAUDIA FERNANDA CAMPUZANO PHYSICIAN ASSISTANT 1083955074
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.