Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RUSSELL DAVIS, DO
ActiveNephrology · BOLIVAR, MO
Registration Details
- NPI Number
- 1821593203
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 27, 2018 (8.1364075123454 yrs)
- Last Updated
- Jan 8, 2026
- License
-
2024032172 (MO)
Practice Information
- Address
-
1160 W PARKVIEW STBOLIVAR, MO, 65613Browse MO providers · Browse ZIP 65613
- Phone
- 4173287373
- Primary Specialty
-
Nephrology
207RN0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.