Individual
SCOTT STEWART RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5405 W 151ST ST, LEAWOOD, KS 66224
(913) 323-8830
(913) 323-8831
Mailing address
5405 W 151ST ST, LEAWOOD, KS 66224-8700
(913) 323-8830
(913) 323-8831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0429142
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100426440H
—
KS
01
—
G93000461
MEDICARE
KS
Enumeration date
06/23/2006
Last updated
05/13/2019
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