Individual
DR. JOHN R RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6080 N OAK TRFY, KANSAS CITY, MO 64118-5158
(816) 453-9232
(816) 455-2423
Mailing address
2700 CLAY EDWARDS DR, SUITE 240, NORTH KANSAS CITY, MO 64116-3251
(816) 691-5287
(816) 346-7690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36959
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063486660
—
MO
05
—
243649753
—
MO
Enumeration date
02/13/2006
Last updated
02/11/2016
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