George Ray Russell Md Pc

LBN: George Ray Russell Md Pc
George Ray Russell Md Pc is an health care organization with primary practice located at 1000 Alpine Ave #50, Boulder CO 80304-3409. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. George Ray Russell Md Pc can be contacted via phone (303) 444-4864, or through Russell, George R via phone (303) 444-4864.

Contact Information

Primary practice address
1000 Alpine Ave #50 Boulder CO 80304-3409
Phone: (303) 444-4864
Fax: (303) 444-4865
Website:
Map and Directions
Authorized official contact:
Name: Russell, George R Doctor of Medicine (MD)
Phone: (303) 444-4864

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 17600 Colorado

Profile Details

NPI number 1588865646
LBN Legal business name George Ray Russell Md Pc
DBA Doing business as
Authorized official Russell, George R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 29th, 2007
Last updated May 7th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588865646 NPPES
Colorado MEDICAID 84307366
Colorado Other GE667695

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