Nelligan, Russell W

Nelligan, Russell W is an individual health care provider with primary practice located at 1400 Us Highway 1 S , St Augustine FL 32084-4211. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Nelligan, Russell W can be contacted via phone (904) 829-2286.

Contact Information

Primary practice address
1400 Us Highway 1 S St Augustine FL 32084-4211
Phone: (904) 829-2286
Fax: (904) 810-5687
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X N5906 Texas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1255542767
LBN Legal business name Nelligan, Russell W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated Jun 19th, 2026 - about 5 months 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 1255542767 NPPES
Louisiana MEDICAID 07877

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