Russell, John R
Russell, John R is an sole proprietor health care provider with primary practice located at 6080 N Oak Trfy , Kansas City MO 64118-5158. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Russell, John R can be contacted via phone (816) 453-9232.Contact Information
Primary practice address
6080 N Oak Trfy
Kansas City MO 64118-5158
Phone: (816) 453-9232
Fax: (816) 455-2423
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 36959 | Missouri |
Profile Details
NPI number | 1063486660 |
---|---|
LBN Legal business name | Russell, John R |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 13th, 2006 |
Last updated | Feb 11th, 2016 - about 9 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 | 1063486660 | NPPES |
Missouri | MEDICAID | 1063486660 | |
Missouri | MEDICAID | 243649753 |
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