person
James R Ennis, DO
General Practice Physician in Holts Summit, Missouri
NPI 1881666865

James R Ennis is a General Practice Physician based in Holts Summit, MO. James R Ennis practices in Holts Summit, MO and has the professional credentials of DO. The NPI Number for James R Ennis is 1881666865 and holds a License No. R6639 (Missouri).

The current practice location address for James R Ennis is 180 Northstar, Holts Summit, MO and can be reached out via phone at 573-896-5115 and via fax at 573-896-4272.

Location: 180 Northstar, Holts Summit, MO, 65043
person
Provider Profile Details
NPI Number
1881666865
Provider Name
James R Ennis
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
180 Northstar, Holts Summit, MO, 65043
Phone Number
573-896-5115
Fax Number
573-896-4272
Provider Enumeration Date
02/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
813149 01 FIRST HEALTH
104257 01 HEALTHLINK
100491 01 BLUE CROSS BLUE SHIELD
7779636 01 CIGNA
240009803 05 MO
501607808 05 MO
institution
Provider Business Practice Location Address Details
Address
180 Northstar
City
State
Zip
65043
Phone Number
573-896-5115
Fax Number
573-896-4272
person
Provider Business Mailing Address Details
Address
180 Northstar
City
State
Zip
65043
Phone Number
573-896-5115
Fax Number
573-896-4272
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
R6639 (Missouri)
Definition
Definition to come...
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