Russell, Robert L
Russell, Robert L is an individual health care provider with primary practice located at 305 Highway 51 , Ridgeland MS 39157-3428. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Russell, Robert L can be contacted via phone (601) 856-9980.Contact Information
Primary practice address
305 Highway 51
Ridgeland MS 39157-3428
Phone: (601) 856-9980
Fax: (601) 856-9994
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 12039 | Mississippi |
Profile Details
| NPI number | 1528151610 |
|---|---|
| LBN Legal business name | Russell, Robert L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Feb 6th, 2017 - about 9 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 | 1528151610 | NPPES |
| Mississippi | MEDICAID | 0015413 |
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