DR. JOHN RUSSELL DAGES


Address: 705 Illinois Avenue, Suite A-14, Joplin, MO 64801-5017
Phone: 4177191346

DR. JOHN RUSSELL DAGES (NPI# 1265647473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265647473
Entity Type Individual
Full Name DR. JOHN RUSSELL DAGES
Credential PHD, LP
Practice Address 705 Illinois Avenue
Suite A-14
Joplin
MO 64801-5017
Practice Telephone 4177191346
Mailing Telephone (417) 719-1346
Enumeration Date 2007-05-11
Last Update Date 2017-06-12
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist 01847 MO Behavioral Health & Social Service Providers
N 103TC1900X Psychologist
Specialization: Counseling
PSY1000308 DC Behavioral Health & Social Service Providers
Y 103TC1900X Psychologist
Specialization: Counseling
01847 MO Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MO 1265647473 05

Office Location

Street Address 705 ILLINOIS AVENUE
SUITE A-14
City JOPLIN
State MO
Zip Code 64801-5017

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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

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Competitor

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City JOPLIN
Zip Code 64801

Improve Information

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Dataset Information

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.

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