The Doctor'S Office, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

R6B25 Issued in MO

Legal business name

THE DOCTOR'S OFFICE, INC.

Practice address

6500 Lansdowne Ave
Saint Louis, MO 63109-2654

Phone

(314) 352-7003

NPI assigned

Mar 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Russell K Won, MDNPI 1245327725

Title

President

Phone

(314) 352-7003

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell KL Won, M.D.

  • General Practice Physician
  • Saint Louis, MO
  • NPI 1245327725
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1891829602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 LANSDOWNE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092654",
            "telephone_number": "314-352-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 LANSDOWNE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092654",
            "telephone_number": "314-352-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTOR'S OFFICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "WON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-352-7003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MO",
            "license": "R6B25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201567013",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.