DR. RUSSELL KL WON (NPI# 1245327725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245327725 |
Entity Type | Individual |
Full Name | DR. RUSSELL KL WON |
Credential | M.D. |
Practice Address |
6500 Lansdowne Ave Saint Louis MO 63109-2654 |
Practice Telephone | 3143527003 |
Mailing Telephone | 3143527003 |
Enumeration Date | 2006-10-06 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | R6B25 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 201567013 | 05 |
Street Address |
6500 LANSDOWNE AVE |
City | SAINT LOUIS |
State | MO |
Zip Code | 63109-2654 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891829602 | The Doctor's Office, Inc. | General Practice | 6500 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2007-03-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013431907 | James Edward Trout | Community Health Worker | 3956 Wenzlick Ave, St Louis, MO 63109 | 2017-08-01 |
1750815023 | Andrea Hyde | Nurse Practitioner | 5302 Chippewa Street, Suite 301, St Louis, MO 63109 | 2017-04-13 |
1215362124 | Alex Sharifian Dds Francis Park Dentistry PC | Dentist | 6650 Chippewa Street, Saint Louis, MO 63109 | 2013-09-10 |
1881993962 | Rachel Elizabeth Hale Hasper | Counselor | 6555 Chippewa, St Louis, MO 63109 | 2011-03-15 |
1730369885 | Janis Marie Lampa | Physical Therapist | 5203 Chippewa, Suite 301, St. Louis, MO 63109 | 2007-11-06 |
1285753772 | James Matthew Jordan | Occupational Therapist | 32 Hampton Village Plaza, St Louis, MO 63109 | 2007-03-28 |
1730224478 | Mercy Health Services, LLC | Optometrist | 34 Hampton Village Plaza, St. Louis, MO 63109 | 2007-02-20 |
1801959903 | John Thomas Doyle | Dentist | 5400 Walsh St, St Louis, MO 63109 | 2006-12-19 |
1649339771 | Residencial Services Corporation | Assisted Living Facility | 5890 Eichelberger, St Louis, MO 63109 | 2006-12-06 |
1316039852 | Gary Raymond Rieser | Dentist | 3915 Watson Road, Suite 205, Saint Louis, MO 63109 | 2006-09-29 |
Find all providers in zip 63109 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790205854 | Zachary Avital Goodman | General Practice | 6642 Clayton Rd # 278, Saint Louis, MO 63117-1602 | 2017-06-20 |
1174926224 | Anita Dewan | General Practice | 9917 Grandview Forest Ct, Saint Louis, MO 63127-0046 | 2014-10-03 |
1356755201 | Jessica Ellie Ma | General Practice | 216 S Kingshighway Blvd Fl 6, 6th Floor, Saint Louis, MO 63110-1026 | 2014-06-19 |
1235550385 | Doctor's On The Way, Inc | General Practice | 712 N 2nd St, Ste 310, Saint Louis, MO 63102-2550 | 2013-12-16 |
1518398916 | John Allen Cooper | General Practice | 40 N Kingshighway Blvd Apt 13f, Saint Louis, MO 63108-1343 | 2013-12-10 |
1417382821 | Hyung T Kim | General Practice | 11 Crestwood Dr, Saint Louis, MO 63105-3032 | 2013-09-05 |
1356617443 | Kirsten Frances Dunn | General Practice | 1040 N Mason Rd Ste 103, Ste 103, Saint Louis, MO 63141-6361 | 2012-03-22 |
1902199623 | Care Plus Medical Group LLC | General Practice | 10650 Gateway Blvd, Saint Louis, MO 63132-1802 | 2011-05-27 |
1437474202 | Debra Lynne Moss | General Practice | 12929 Ballantine Ct, Saint Louis, MO 63146-3701 | 2010-04-05 |
1558538850 | Patrice Lynn Wakefield | General Practice | 514 Donne Ave, Saint Louis, MO 63130-3918 | 2008-05-15 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63109 |
Please comment or provide details below to improve the information on DR. RUSSELL KL WON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.