Cully, Brent Ellis

Cully, Brent Ellis is an individual health care provider with primary practice located at 2401 Gillham Rd , Kansas City MO 64108-4619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Cully, Brent Ellis can be contacted via phone (816) 234-3270.

Contact Information

Primary practice address
2401 Gillham Rd Kansas City MO 64108-4619
Phone: (816) 234-3270
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 04-30149 Kansas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2000146371 Missouri

Profile Details

NPI number 1114921533
LBN Legal business name Cully, Brent Ellis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Aug 20th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114921533 NPPES
Missouri MEDICAID 1114921533
Missouri MEDICAID 100457090D

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