Russell, Kimberly
Russell, Kimberly is an individual health care provider with primary practice located at 35 Pearl St Ste 100 , Brockton MA 02301-2866. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Russell, Kimberly can be contacted via phone (508) 588-8034.Contact Information
Primary practice address
35 Pearl St Ste 100
Brockton MA 02301-2866
Phone: (508) 588-8034
Fax: (508) 588-5969
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 269874 | Massachusetts |
Profile Details
| NPI number | 1326305905 |
|---|---|
| LBN Legal business name | Russell, Kimberly |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2012 |
| Last updated | Apr 17th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326305905 | NPPES |
| Massachusetts | MEDICAID | 110102733A |
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