# DR. RUSSELL C CANTRELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1023097904
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 103654 | MO | Yes |

## Other

- **Enumeration date:** 01/10/2006
- **Last updated:** 02/06/2017

## 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 |