Russell, Scott Anthony

Russell, Scott Anthony is an individual health care provider with primary practice located at 3201 S Austin Ave Ste 330, Georgetown TX 78626-7545. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Russell, Scott Anthony can be contacted via phone (512) 864-3183.

Contact Information

Primary practice address
3201 S Austin Ave Ste 330 Georgetown TX 78626-7545
Phone: (512) 864-3183
Fax: (512) 930-3409
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X H4662 Texas

Profile Details

NPI number 1790781706
LBN Legal business name Russell, Scott Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Sep 29th, 2010 - about 16 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 1790781706 NPPES
Texas MEDICAID 117275102
Texas Other 4232187

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