Russell, Evan

Russell, Evan is an individual health care provider with primary practice located at 2700 Clay Edwards Dr Ste 240 , North Kansas City MO 64116-3254. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Russell, Evan can be contacted via phone (816) 455-0681.

Contact Information

Primary practice address
2700 Clay Edwards Dr Ste 240 North Kansas City MO 64116-3254
Phone: (816) 455-0681
Fax: (816) 455-5294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2017013099 Missouri
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X AP2282058A Ohio
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2017013099 Missouri

Profile Details

NPI number 1902211808
LBN Legal business name Russell, Evan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2014
Last updated Jul 21st, 2022 - about 4 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 1902211808 NPPES
Missouri MEDICAID 1902211808

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