Russell, Duane L.

Russell, Duane L. is an individual health care provider with primary practice located at 117 S 11Th Ave , Laurel MS 39440-4312. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Russell, Duane L. can be contacted via phone (601) 425-3033.

Contact Information

Primary practice address
117 S 11Th Ave Laurel MS 39440-4312
Phone: (601) 425-3033
Fax: (601) 428-6561
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 017375 Mississippi

Profile Details

NPI number 1962408658
LBN Legal business name Russell, Duane L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Jul 11th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962408658 NPPES
Mississippi MEDICAID 0124892

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