Individual
DR. BRIAN K ELLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2100 W MAIN ST, SEDALIA, MO 65301-2351
(660) 826-5750
(660) 829-5750
Mailing address
2100 W MAIN ST, SEDALIA, MO 65301-2351
(660) 826-5750
(660) 829-5750
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
DOR5N34
MO
207X00000X
Orthopaedic Surgery Physician
Primary
R5N34
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200015237
RR MEDICARE
MO
Enumeration date
09/26/2006
Last updated
06/06/2022
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