Provider Demographics
NPI:1861429458
Name:SINCLAIR WEBBER, ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:SINCLAIR WEBBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1418 S MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3543
Mailing Address - Country:US
Mailing Address - Phone:785-242-1620
Mailing Address - Fax:785-242-3825
Practice Address - Street 1:1418 S MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3543
Practice Address - Country:US
Practice Address - Phone:785-242-1620
Practice Address - Fax:785-242-3825
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27513207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS053625OtherKANSAS BLUE CROSS BLUE SH
KS25668014OtherKANSAS CITY BC/BS
KS5242654OtherAETNA
KS100316620AMedicaid
KS7275547001OtherCIGNA
KS656100OtherHEALTHWAVE
KSG73917Medicare UPIN
KY053625Medicare ID - Type UnspecifiedKANSAS MEDICARE