Russell, Aaron Jacob
Russell, Aaron Jacob is an individual health care provider with primary practice located at 969 N Mason Rd Div Im Dermatology, Ste 220, Saint Louis MO 63141-6282. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Russell, Aaron Jacob can be contacted via phone (314) 273-3376.Contact Information
Primary practice address
969 N Mason Rd Div Im Dermatology, Ste 220
Saint Louis MO 63141-6282
Phone: (314) 273-3376
Fax: (888) 682-0525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | 2021011092 | Missouri |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 2021011092 | Missouri |
Profile Details
| NPI number | 1568813863 |
|---|---|
| LBN Legal business name | Russell, Aaron Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2016 |
| Last updated | Apr 17th, 2025 - about last year |
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 | 1568813863 | NPPES |
| Missouri | MEDICAID | 200061535 |
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