Russell, Wesley Alan

Russell, Wesley Alan is an individual health care provider with primary practice located at 11050 Parkview Circle Dr , Fort Wayne IN 46845. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Russell, Wesley Alan can be contacted via phone (260) 266-9100.

Contact Information

Primary practice address
11050 Parkview Circle Dr Fort Wayne IN 46845
Phone: (260) 266-9100
Fax: (260) 266-9110
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 01072532A Indiana

Profile Details

NPI number 1508029497
LBN Legal business name Russell, Wesley Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2008
Last updated Jun 15th, 2018 - about 8 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 1508029497 NPPES
Indiana MEDICAID 201163340
Indiana MEDICAID 0083773
Indiana MEDICAID 1508029497

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