Provider Demographics
NPI:1083301295
Name:DAY, ELLINGTON GRACE (PA)
Entity Type:Individual
Prefix:
First Name:ELLINGTON
Middle Name:GRACE
Last Name:DAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4010 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-4079
Mailing Address - Country:US
Mailing Address - Phone:912-288-4151
Mailing Address - Fax:
Practice Address - Street 1:100 FRIST CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3578
Practice Address - Country:US
Practice Address - Phone:706-494-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-04-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant