Hennessey, Russell B

Hennessey, Russell B is an individual health care provider with primary practice located at 1000 S Spruce St , Vivian LA 71082-3232. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Hennessey, Russell B can be contacted via phone (318) 375-3239.

Contact Information

Primary practice address
1000 S Spruce St Vivian LA 71082-3232
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 022466 Louisiana

Profile Details

NPI number 1497793236
LBN Legal business name Hennessey, Russell B
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Jul 8th, 2007 - about 18 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 1497793236 NPPES
Louisiana MEDICAID 1944569

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