Gross, Russell J

Gross, Russell J is an individual health care provider with primary practice located at 1995 Highway 51 S Suite 203, Covington TN 38019-3635. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Gross, Russell J can be contacted via phone (901) 475-5422.

Contact Information

Primary practice address
1995 Highway 51 S Suite 203 Covington TN 38019-3635
Phone: (901) 475-5422
Fax: (901) 475-5595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X A31869 California
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 40003 Tennessee
Allopathic & Osteopathic Physicians / Surgery 208600000X 31869 California

Profile Details

NPI number 1548228588
LBN Legal business name Gross, Russell J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jan 29th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548228588 NPPES
Tennessee Other 4167965 BCBS TN
Tennessee Other 0989653 BCBS TN
Tennessee Other 42359 BCBS TN
Tennessee MEDICAID 1507224 BCBS TN

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