Kellenberger, Ricky

Kellenberger, Ricky is an individual health care provider with primary practice located at 202 State St Suite A, Fort Scott KS 66701-2031. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Kellenberger, Ricky can be contacted via phone (620) 223-3950.

Contact Information

Primary practice address
202 State St Suite A Fort Scott KS 66701-2031
Phone: (620) 223-3950
Fax: (620) 223-1302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2000157954 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 05-19720 Kansas

Profile Details

NPI number 1700864568
LBN Legal business name Kellenberger, Ricky
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Oct 20th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700864568 NPPES
Missouri MEDICAID 245111802

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