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Individual

DR. RUSSELL SCOTT GRIMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1005 W SAINT MAARTENS DR STE A, SAINT JOSEPH, MO 64506-2989
(816) 364-2338
(816) 364-1003
Mailing address
1005 W SAINT MAARTENS DR STE A, SAINT JOSEPH, MO 64506-2989
(816) 364-2338
(816) 364-1003

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2006000709
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004030044
PTAN
KS
05
10029888302
NE
01
1588635361
BLUE CROSS AND BLUE SHIELD OF KANSAS
KS
05
30005286470001
KS
Enumeration date
01/30/2006
Last updated
03/11/2026
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