Individual
DR. RUSSELL WAYNE BOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
(970) 472-9381
Mailing address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
(970) 472-9381
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26009
NE
207L00000X
Anesthesiology Physician
Primary
DR.0029916
CO
207L00000X
Anesthesiology Physician
F5473
TX
207L00000X
Anesthesiology Physician
TL#1443
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01299163
—
CO
05
—
102557100
—
WY
Enumeration date
10/06/2005
Last updated
06/06/2013
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