Mary Russell, is a
Physical Medicine & Rehabilitation physician based in Lebanon, Missouri. Mary Russell is licensed to practice in Missouri (license number 2007022074) and her current practice location is 144 Evergreen Pkwy, Lebanon, Missouri. She can be reached at her office (for appointments etc.) via phone at
(217) 222-6800.
NPI number for Mary Russell is 1316460389 and her current mailing address is 1549 Northbrook St, Lebanon, Missouri. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1316460389.
Physician's Profile
| Full Name | Mary Russell |
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| Gender | Female |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 144 Evergreen Pkwy, Lebanon, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1316460389
- Provider Enumeration Date: 07/21/2017
- Last Update Date: 07/21/2017
Medical Identifiers
Medical identifiers for Mary Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316460389 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 2007022074 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Russell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mary Russell,
1549 Northbrook St,
Lebanon, MO 65536-4319
Ph: (217) 222-6800 | Mary Russell,
144 Evergreen Pkwy,
Lebanon, MO 65536-7056
Ph: (217) 222-6800 |
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