Bobo, Russell Wayne

Bobo, Russell Wayne is an individual health care provider with primary practice located at 1236 E Elizabeth St Suite 1, Fort Collins CO 80524-4000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bobo, Russell Wayne can be contacted via phone (970) 224-2985.

Contact Information

Primary practice address
1236 E Elizabeth St Suite 1 Fort Collins CO 80524-4000
Phone: (970) 224-2985
Fax: (970) 472-9381
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X DR.0029916 Colorado
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 26009 Nebraska
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X F5473 Texas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X TL#1443 Wyoming

Profile Details

NPI number 1972591733
LBN Legal business name Bobo, Russell Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Jun 6th, 2013 - about 12 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 1972591733 NPPES
Colorado MEDICAID 01299163
Colorado MEDICAID 102557100

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