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Individual

DR. STEVEN PHILLIP ELLIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3801 S NATIONAL AVE STE 900, SPRINGFIELD, MO 65807
(417) 875-3087
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2018014545
MO
2084N0400X
Neurology Physician
R1743
TX
2084N0600X
Clinical Neurophysiology Physician
Primary
2018014545
MO
2084N0600X
Clinical Neurophysiology Physician
R1743
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821431123
MO
Enumeration date
04/17/2013
Last updated
12/10/2025
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