Jasper, Alan Lawrence Russell

Jasper, Alan Lawrence Russell is an sole proprietor health care provider with primary practice located at 1601 Watson Blvd Medical Education, Warner Robins GA 31093-3431. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Jasper, Alan Lawrence Russell can be contacted via phone (478) 922-4281.

Contact Information

Primary practice address
1601 Watson Blvd Medical Education Warner Robins GA 31093-3431
Phone: (478) 922-4281
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2825 Tennessee
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5567 Georgia

Profile Details

NPI number 1124371604
LBN Legal business name Jasper, Alan Lawrence Russell
Credentials D.O. MBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2012
Last updated Apr 22nd, 2021 - about 5 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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