Provider Demographics
NPI:1285656322
Name:OSGUTHORPE, RUSSELL J (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:J
Last Name:OSGUTHORPE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 8221
Mailing Address - Street 2:7425 FORSYTH
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-8221
Mailing Address - Country:US
Mailing Address - Phone:314-935-0770
Mailing Address - Fax:314-935-0575
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:SUITE C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6050
Practice Address - Fax:314-454-4633
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-04-25
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Provider Licenses
StateLicense IDTaxonomies
MO20040354612080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases