Provider Demographics
NPI:1073860532
Name:TROWBRIDGE, DENISE RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:RUSSELL
Last Name:TROWBRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NW BLUE PKWY
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5799
Mailing Address - Country:US
Mailing Address - Phone:816-251-0578
Mailing Address - Fax:
Practice Address - Street 1:777 NW BLUE PKWY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5799
Practice Address - Country:US
Practice Address - Phone:816-251-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3P002085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology