Russell, Robert Joseph

Russell, Robert Joseph is an individual health care provider with primary practice located at 539C Highway 80 W , Clinton MS 39056-4193. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Russell, Robert Joseph can be contacted via phone (601) 924-7489.

Contact Information

Primary practice address
539C Highway 80 W Clinton MS 39056-4193
Fax: (601) 924-0988
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 14410 Mississippi

Profile Details

NPI number 1144331422
LBN Legal business name Russell, Robert Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 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 1144331422 NPPES
Mississippi MEDICAID 0119425

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