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:
Health care specialties
Specialty | Code | License # | 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 13 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700864568 | NPPES |
Missouri | MEDICAID | 245111802 |
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