Anderson, Russell Steven

Anderson, Russell Steven is an individual health care provider with primary practice located at 777 N Main St , Tooele UT 84074-1611. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Anderson, Russell Steven can be contacted via phone (435) 843-2364.

Contact Information

Primary practice address
777 N Main St Tooele UT 84074-1611
Phone: (435) 843-2364
Fax: (435) 228-0062
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5148252-8904 Utah
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5148252-1204 Utah

Profile Details

NPI number 1548407513
LBN Legal business name Anderson, Russell Steven
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2009
Last updated Aug 7th, 2023 - about 3 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 1548407513 NPPES
Utah MEDICAID 1548407513

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