Individual
ROBERT J ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3850 S NATIONAL AVE, SUITE 600, SPRINGFIELD, MO 65807-5287
(417) 882-4880
(417) 882-7843
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
R8N50
MO
207RX0202X
Medical Oncology Physician
R8N50
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0628420001
DMERC
MO
01
—
129419
ANTHEM BCBS
MO
05
—
204988307
—
MO
01
—
3600111
UNITED HEALTHCARE
MO
01
—
830006713
RAILROAD MEDICARE
MO
Enumeration date
03/14/2006
Last updated
07/09/2025
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