Mr. Ellis Ray Tackett III, ATCLAT
Mr. Ellis Ray Tackett III, ATCLAT is a Specialist in Pikeville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2015.
- Licensed in
- KY
- In the registry since
- 2015
Practice location Address checks out
147 Sycamore StPikeville, KY 41501-9118
Phone: (606) 213-1620
Fax: (606) 218-5353
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence AT1092 (KY) |
|---|
Record details
| NPI number | 1821489576 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | ATCLAT |
| Sole proprietor | No |
| NPI enumerated | February 16, 2015 |
| Last updated in NPPES | February 16, 2015 |
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