Davis, John Russell

Davis, John Russell is an individual health care provider with primary practice located at 4320 Wornall Rd Suite 50, Kansas City MO 64111-5941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Davis, John Russell can be contacted via phone (816) 931-3312.

Contact Information

Primary practice address
4320 Wornall Rd Suite 50 Kansas City MO 64111-5941
Phone: (816) 931-3312
Fax: (816) 531-9862
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 2010001724 Missouri
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 04-34175 Kansas

Profile Details

NPI number 1891775920
LBN Legal business name Davis, John Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Mar 20th, 2013 - about 13 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 1891775920 NPPES
Missouri Other MA1815 MEDICARE
Missouri MEDICAID 149549001 MEDICARE
Missouri MEDICAID 209231208 MEDICARE
Missouri MEDICAID 200009120A MEDICARE

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