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Individual
DR. RUSSELL C CANTRELL
Active
Individual
DR. RUSSELL C CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
103654
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0425207002
CIGNA
MO
01
—
18346
BLUE CROSS BLUE SHIELD
MO
01
—
227927
HEALTHLINK
MO
01
—
2300015
UNITED HEALTH CARE
MO
01
—
4486251
AETNA
MO
01
—
49861
GREAT WEST
MO
Enumeration date
01/10/2006
Last updated
02/06/2017
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