Kizor, Russell Scott
Kizor, Russell Scott is an individual health care provider with primary practice located at 22 Bramhall St , Portland ME 04102-3134. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Kizor, Russell Scott can be contacted via phone (207) 662-0111.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD24888 | Maine |
Profile Details
| NPI number | 1548792344 |
|---|---|
| LBN Legal business name | Kizor, Russell Scott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2017 |
| Last updated | Jan 7th, 2022 - about 4 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 | 1548792344 | NPPES |
| Maine | MEDICAID | 1548792344 |
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