Russo, Joseph Scott

Russo, Joseph Scott is an individual health care provider with primary practice located at 1300 Johnson St , Elkhart IN 46514-3406. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Russo, Joseph Scott can be contacted via phone (574) 903-7101.

Contact Information

Primary practice address
1300 Johnson St Elkhart IN 46514-3406
Phone: (574) 903-7101
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X DO-03591 Iowa
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001759A Indiana

Profile Details

NPI number 1891791786
LBN Legal business name Russo, Joseph Scott
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated May 31st, 2019 - about 7 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 1891791786 NPPES
Indiana Other P00186778 RAILROAD MEDICARE
Indiana Other 000000355430 RAILROAD MEDICARE
Indiana MEDICAID 200120950 RAILROAD MEDICARE

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