Mr Russell Fowler, DC | |
1675 E Seminole St, Suite H2, Springfield, MO 65804-2490 | |
(417) 881-2295 | |
(417) 881-4282 |
Full Name | Mr Russell Fowler |
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Gender | Male |
Speciality | Chiropractic |
Experience | 25 Years |
Location | 1675 E Seminole St, Springfield, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124194519 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 7087 (Arizona) | Primary |
111N00000X | Chiropractor | 20144016190 (Missouri) | Secondary |
Provider Name | Russell Fowler Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1972755494 PECOS PAC ID: 8426119215 Enrollment ID: O20140627000225 |
Mailing Address | Practice Location Address |
---|---|
Mr Russell Fowler, DC Po Box 10182, Springfield, MO 65808-0182 Ph: (602) 373-5115 | Mr Russell Fowler, DC 1675 E Seminole St, Suite H2, Springfield, MO 65804-2490 Ph: (417) 881-2295 |
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