Russell, George V
Russell, George V is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Trauma, which is considered as his primary health care specialty. Russell, George V can be contacted via phone (601) 815-1277.Contact Information
Primary practice address
2500 N State St
Jackson MS 39216-4500
Phone: (601) 815-1277
Fax: (601) 815-1722
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 16970 | Mississippi |
Profile Details
| NPI number | 1629072509 |
|---|---|
| LBN Legal business name | Russell, George V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Jan 25th, 2024 - 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 | 1629072509 | NPPES |
| Mississippi | Other | 512G700003 | MEDICARE UP |
| Mississippi | Other | 512I200009 | MEDICARE UP |
| Mississippi | MEDICAID | 0120719 | MEDICARE UP |
| Mississippi | Other | P00628048 | MEDICARE UP |
| Mississippi | MEDICAID | 192085 | MEDICARE UP |
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