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Contact Information

STEPHEN C ELLIS, MD
19600 E 39TH ST S
INDEPENDENCE, MO64057-2301
 Phone: 913-428-2900
 Fax: 913-428-2951
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for STEPHEN C ELLIS · (Male)

NPI Number 1275515314
Status Active
Credentials MD
Entity Individual
Enumeration date 11/15/2005
Last updated 08/18/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 04-21076
  • MO License # R5J54
  • KS Medicaid 100192350C
  • MO Medicaid 202168845
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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