Organization
RUSSELL W. HART, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL W HART OD (OWNER)
(620) 245-9921
Entity
Organization
Contact information
Practice address
205 S CENTENNIAL DR, SUITE A, MCPHERSON, KS 67460-4012
(620) 245-9921
(785) 539-2021
Mailing address
732 BRIERWOOD DR, MANHATTAN, KS 66502-3130
(785) 587-8752
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1396-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
651142
BLUE CROSS BLUE SHIELD
KS
Enumeration date
01/09/2007
Last updated
08/22/2020
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