Dilley, Russell S

Dilley, Russell S is an individual health care provider with primary practice located at 1400 N Ritter Ave Suite # 520, Indianapolis IN 46219-3052. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Dilley, Russell S can be contacted via phone (317) 355-1234.

Contact Information

Primary practice address
1400 N Ritter Ave Suite # 520 Indianapolis IN 46219-3052
Phone: (317) 355-1234
Fax: (317) 355-1505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 01026646 Indiana

Profile Details

NPI number 1891724167
LBN Legal business name Dilley, Russell S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Sep 7th, 2017 - 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 1891724167 NPPES
Indiana Other P01214606 RR MEDICARE PTAN
Indiana MEDICAID 100064180A RR MEDICARE PTAN

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