Russell, Robert Blaine
Russell, Robert Blaine is an individual health care provider with primary practice located at 1701 Lacey St , Cape Girardeau MO 63701-5230. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Russell, Robert Blaine can be contacted via phone (573) 335-0185.Contact Information
Primary practice address
1701 Lacey St
Cape Girardeau MO 63701-5230
Phone: (573) 335-0185
Fax: (573) 335-0793
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | R6D82 | Missouri |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207LC0200X | R6D82 | Missouri |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | R6D82 | Missouri |
Profile Details
| NPI number | 1992814966 |
|---|---|
| LBN Legal business name | Russell, Robert Blaine |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1992814966 | NPPES |
| Missouri | Other | 105181 | BLUE CROSS BLUE SHIELD |
| Missouri | Other | 178715 | BLUE CROSS BLUE SHIELD |
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