Individual
DR. MICHAEL ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8600 QUIVIRA RD STE 100, LENEXA, KS 66215-2857
(913) 831-7400
(913) 831-7409
Mailing address
8600 QUIVIRA RD STE 100, LENEXA, KS 66215-2857
(913) 831-7400
(913) 831-7409
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
04-46569
KS
207W00000X
Ophthalmology Physician
2022028016
MO
207W00000X
Ophthalmology Physician
35138864
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
04-46569
KS
207WX0107X
Retina Specialist (Ophthalmology) Physician
2022028016
MO
Other
Enumeration date
03/22/2016
Last updated
09/06/2022
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