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:
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Health care specialties

SpecialtyCodeLicense #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 2 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 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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