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Individual

DR. RUSSELL STEWART YOCUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2600 RUNNING HORSE ROAD, PLATTE CITY, MO 64079-9761
(816) 858-2200
(816) 858-3611
Mailing address
9411 N OAK TRFY, SUITE LL1, KANSAS CITY, MO 64155-2262
(816) 436-7072
(816) 436-2743

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3J21
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080147120
RAILROAD MEDICARE
01
14730013
BCBS OF KC INDIVIDUAL #
05
242638203
MO
Enumeration date
01/31/2006
Last updated
09/01/2016
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