James R Ennis, DO | |
180 Northstar, Holts Summit, MO 65043 | |
(573) 896-5115 | |
(573) 896-4272 |
Full Name | James R Ennis |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 180 Northstar, Holts Summit, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881666865 | NPI | - | NPPES |
813149 | Other | FIRST HEALTH | |
104257 | Other | HEALTHLINK | |
100491 | Other | BLUE CROSS BLUE SHIELD | |
7779636 | Other | CIGNA | |
240009803 | Medicaid | MO | |
501607808 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | R6639 (Missouri) | Primary |
Mailing Address | Practice Location Address |
---|---|
James R Ennis, DO 180 Northstar, Capital Region Medical Clinic, Holts Summit, MO 65043 Ph: (573) 896-5115 | James R Ennis, DO 180 Northstar, Holts Summit, MO 65043 Ph: (573) 896-5115 |
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