Mccullough, Russell Wade
Mccullough, Russell Wade is an individual health care provider with primary practice located at 3601 Ne Ralph Powell Rd , Lees Summit MO 64064-2357. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mccullough, Russell Wade can be contacted via phone (816) 251-1200.Contact Information
Primary practice address
3601 Ne Ralph Powell Rd
Lees Summit MO 64064-2357
Phone: (816) 251-1200
Fax: (816) 251-1280
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 2001006773 | Missouri |
Profile Details
| NPI number | 1346223468 |
|---|---|
| LBN Legal business name | Mccullough, Russell Wade |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1346223468 | NPPES |
| Missouri | MEDICAID | 209336205 |
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