Davis, Russell Kelso

Davis, Russell Kelso is an sole proprietor health care provider with primary practice located at 318 E. Main St. , Havelock NC 28532-2214. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Davis, Russell Kelso can be contacted via phone (252) 444-3377.

Contact Information

Primary practice address
318 E. Main St. Havelock NC 28532-2214
Phone: (252) 444-3377
Fax: (252) 444-3529
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 2801 North Carolina

Profile Details

NPI number 1982607966
LBN Legal business name Davis, Russell Kelso
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated May 17th, 2016 - 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 1982607966 NPPES
North Carolina Other 616120 ACN IDENTIFICATION #
North Carolina Other 7167352 ACN IDENTIFICATION #
North Carolina Other 0844V ACN IDENTIFICATION #
North Carolina MEDICAID 890844V ACN IDENTIFICATION #

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