Organization
RUSSELL E TACKETT MDPC
Active
Organization
RUSSELL E TACKETT MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL EDWARD TACKETT MD (PRESIDENT)
(816) 361-0277
Entity
Organization
Contact information
Practice address
6400 PROSPECT AVE, SUITE 440, KANSAS CITY, MO 64132-1100
(816) 361-0277
(816) 361-4733
Mailing address
6400 PROSPECT AVE, SUITE 440, KANSAS CITY, MO 64132-1100
(816) 361-0277
(816) 361-4733
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
R6B18
MO
Other
Enumeration date
02/06/2007
Last updated
09/07/2007
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