Cantrell, Russell C

Cantrell, Russell C is an individual health care provider with primary practice located at 1001 S. Kirkwood Road Suite 120, Saint Louis MO 63122-7250. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Cantrell, Russell C can be contacted via phone (314) 966-8887.

Contact Information

Primary practice address
1001 S. Kirkwood Road Suite 120 Saint Louis MO 63122-7250
Phone: (314) 966-8887
Fax: (314) 966-3869
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 103654 Missouri

Profile Details

NPI number 1023097904
LBN Legal business name Cantrell, Russell C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Feb 6th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023097904 NPPES
Missouri Other 0425207002 CIGNA
Missouri Other 227927 CIGNA
Missouri Other 4486251 CIGNA
Missouri Other 18346 CIGNA
Missouri Other 2300015 CIGNA
Missouri Other 49861 CIGNA

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