Davis, Russell Kelso
Davis, Russell Kelso is an sole proprietor health care provider with primary practice located at 318 E. Main St. , Havelock NC 28532-2214. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Davis, Russell Kelso can be contacted via phone (252) 444-3377.Contact Information
Primary practice address
318 E. Main St.
Havelock NC 28532-2214
Phone: (252) 444-3377
Fax: (252) 444-3529
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Sports Physician | 111NS0005X | 2801 | North Carolina |
Profile Details
| NPI number | 1982607966 |
|---|---|
| LBN Legal business name | Davis, Russell Kelso |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | May 17th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982607966 | NPPES |
| North Carolina | Other | 616120 | ACN IDENTIFICATION # |
| North Carolina | Other | 7167352 | ACN IDENTIFICATION # |
| North Carolina | Other | 0844V | ACN IDENTIFICATION # |
| North Carolina | MEDICAID | 890844V | ACN IDENTIFICATION # |
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