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
Fax: (816) 455-2423
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063486660 NPPES
Missouri MEDICAID 1063486660
Missouri MEDICAID 243649753

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