Ellis, Ronald L.

Ellis, Ronald L. is an individual health care provider with primary practice located at 1229 E Seminole St , Springfield MO 65804-2227. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Ellis, Ronald L. can be contacted via phone (417) 820-2064.

Contact Information

Primary practice address
1229 E Seminole St Springfield MO 65804-2227
Phone: (417) 820-2064
Fax: (417) 820-8716
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X R6G80 Missouri

Profile Details

NPI number 1942342936
LBN Legal business name Ellis, Ronald L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated May 3rd, 2013 - about 12 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 1942342936 NPPES
Missouri Other 82676 AR BLUE SHIELD #
Missouri MEDICAID 122768001 AR BLUE SHIELD #
Missouri MEDICAID 202444436 AR BLUE SHIELD #
Missouri MEDICAID 202444444 AR BLUE SHIELD #

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