Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 04-26174 | KS |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD110162 | MO |
NPI | 1942354246 |
---|---|
Provider Name | Dr. Steven Frank Ellis |
First Address | Overland Park, KS 66211-1891 |
Second Address | Overland Park, KS 66211-1891 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 02/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1000267 | UNITEDHEALTH CARE (01) | KS |
100189220A | (05) | KS |
100611 | BCBS OF KS (01) | KS |
22918011 | BCBS OF KC (01) | MO |
G24944 | (02) |