Provider Demographics
NPI:1356632111
Name:RUSSELL, SARAH ELIZABETH (DPM)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:5401 COLLEGE BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1661
Mailing Address - Country:US
Mailing Address - Phone:913-233-8816
Mailing Address - Fax:913-228-1190
Practice Address - Street 1:5401 COLLEGE BLVD STE 204
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1661
Practice Address - Country:US
Practice Address - Phone:913-233-8816
Practice Address - Fax:913-228-1190
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT909213ES0103X
KS12-00424213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery