Degroote, Russell A

Degroote, Russell A is an individual health care provider with primary practice located at 7559 N Tongass Ave , Ketchikan AK 99901-9182. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Degroote, Russell A can be contacted via phone (907) 247-9999.

Contact Information

Primary practice address
7559 N Tongass Ave Ketchikan AK 99901-9182
Phone: (907) 247-9999
Fax: (206) 339-1460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 114055 Alaska
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 26594 Nebraska
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD60661553 Washington

Profile Details

NPI number 1689684771
LBN Legal business name Degroote, Russell A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jan 10th, 2022 - 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 1689684771 NPPES
Colorado MEDICAID 30471753

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