Russell, Mark S
Russell, Mark S is an individual health care provider with primary practice located at 3633 Central Avenue Suite D, Hot Springs AR 71913-6475. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Russell, Mark S can be contacted via phone (501) 623-6693.Contact Information
Primary practice address
3633 Central Avenue Suite D
Hot Springs AR 71913-6475
Phone: (501) 623-6693
Fax: (501) 623-9403
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | C6875 | Arkansas |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | C-6875 | Arkansas |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | C-6875 | Arkansas |
Profile Details
| NPI number | 1982694428 |
|---|---|
| LBN Legal business name | Russell, Mark S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Mar 7th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982694428 | NPPES |
| Arkansas | MEDICAID | 110923001 | |
| Arkansas | Other | 546256799 | |
| Arkansas | Other | C6875 |
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