Libby, Russell Clark
Libby, Russell Clark is an individual health care provider with primary practice located at 3020 Hamaker Ct Suite 200, Fairfax VA 22031-2238. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Libby, Russell Clark can be contacted via phone (703) 573-2432.Contact Information
Primary practice address
3020 Hamaker Ct Suite 200
Fairfax VA 22031-2238
Phone: (703) 573-2432
Fax: (703) 280-9350
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0101033734 | Virginia |
Profile Details
| NPI number | 1205996576 |
|---|---|
| LBN Legal business name | Libby, Russell Clark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 9th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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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