Basic Information
| Provider Information | |||||||||
| NPI: | 1417926585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELLINGSON | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | INGARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3500 ELMORE PL | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235091324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7576220190 | ||||||||
| FaxNumber: | 7579531908 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 JOHN PAUL JONES CIR | ||||||||
| Address2: | DEPT. OF ORTHOPAEDIC SURGERY - | ||||||||
| City: | PORTSMOUTH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579531814 | ||||||||
| FaxNumber: | 7579531908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | 0101102548 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.