Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Russell

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1316460389

Mary Russell is a Physical Medicine & Rehabilitation Physician in Lebanon, Missouri. Licensed in Missouri. Registered with an NPI since 2017.

Licensed in
MO
In the registry since
2017
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Practice location Address checks out

144 Evergreen Pkwy
Lebanon, MO 65536-7056
Phone: (217) 222-6800
Fax: (636) 528-7335
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 2007022074 (MO)

Record details

NPI number1316460389
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 21, 2017
Last updated in NPPESJuly 21, 2017
Mailing address1549 Northbrook St, Lebanon, MO 65536-4319