Russell, Kirk Shane

Russell, Kirk Shane is an individual health care provider with primary practice located at Womack Army Medical Center 2817 Rock Merritt Ave , Fort Liberty NC 28310-6644. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Russell, Kirk Shane can be contacted via phone (910) 907-8707.

Contact Information

Primary practice address
Womack Army Medical Center 2817 Rock Merritt Ave Fort Liberty NC 28310-6644
Phone: (910) 907-8707
Fax: (910) 907-8707
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 230324 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2014-02064 North Carolina
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 2014-02064 North Carolina

Profile Details

NPI number 1912075631
LBN Legal business name Russell, Kirk Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2006
Last updated Jan 31st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912075631 NPPES
North Carolina MEDICAID 1912075631

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