Individual
RUSSELL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1160 W PARKVIEW ST, BOLIVAR, MO 65613
(417) 328-7373
Mailing address
1160 W PARKVIEW ST, BOLIVAR, MO 65613
(417) 328-7373
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
2024032172
MO
Other
Enumeration date
03/27/2018
Last updated
01/08/2026
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