| John J. Russell, Md, Pc | |
|
1435 N Mount Auburn Rd Suite 200 Cape Girardeau MO 63701-2171 | |
| (573) 335-4209 | |
| (573) 335-5524 |
| Full Name | John J. Russell, Md, Pc |
|---|---|
| Speciality | Pediatrics |
| Location | 1435 N Mount Auburn Rd, Cape Girardeau, Missouri |
| Authorized Official Name and Position | John J Russell (PRESIDENT) |
| Authorized Official Contact | 5733354209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John J. Russell, Md, Pc 1435 N Mount Auburn Rd Suite 200 Cape Girardeau MO 63701-2171 Ph: (573) 335-4209 | John J. Russell, Md, Pc 1435 N Mount Auburn Rd Suite 200 Cape Girardeau MO 63701-2171 Ph: (573) 335-4209 |
| NPI Number | 1811020225 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811020225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 100521 (Missouri) | Primary |
| 208000000X | Pediatrics | 100521 (Missouri) | Primary |
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