Individual
DR. JOHN C ELLIS
Active
Individual
DR. JOHN C ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R8E78
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008021
UHC
MO
01
—
11540041
BCBS OF KC
MO
01
—
204510882
CHAMPUS
MO
01
—
4001449
AETNA
MO
01
—
9852
BNDD
MO
Enumeration date
02/14/2006
Last updated
03/07/2023
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