Individual
DR. RICKY KELLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
202 STATE ST, SUITE A, FORT SCOTT, KS 66701-2031
(620) 223-3950
(620) 223-1302
Mailing address
202 STATE ST STE A, FORT SCOTT, KS 66701-2067
(620) 223-3950
(620) 223-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2000157954
MO
207Q00000X
Family Medicine Physician
Primary
05-19720
KS
208M00000X
Hospitalist Physician
05-19720
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245111802
—
MO
Enumeration date
01/03/2006
Last updated
09/11/2025
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