ROBERT BLAINE RUSSELL

CAPE GIRARDEAU, MO
NPI1992814966
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: MO  R6D82)
Additional Taxonomies207LC0200X Anesthesiology, Critical Care Medicine
(Licence: MO  R6D82)
207LP2900X Anesthesiology, Pain Medicine
(Licence: MO  R6D82)
Enumeration Date2006-08-30
Last Update Date2007-07-08
Business Address
-- ROBERT BLAINE RUSSELL D.O.
1701 LACEY ST
CAPE GIRARDEAU, MO 63701-5230
Phone number: 573-335-0185
Mailing Address
-- ROBERT BLAINE RUSSELL D.O.
721 N SUNSET BLVD
CAPE GIRARDEAU, MO 63701-4532
Phone number: