Fothergill, Russell Eugene

Fothergill, Russell Eugene is an individual health care provider with primary practice located at 1713 Sw H K Dodgen Loop Ste 100 , Temple TX 76502-1836. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Fothergill, Russell Eugene can be contacted via phone (254) 771-8100.

Contact Information

Primary practice address
1713 Sw H K Dodgen Loop Ste 100 Temple TX 76502-1836
Phone: (254) 771-8100
Fax: (254) 771-8101
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X L2890 Texas

Profile Details

NPI number 1063472504
LBN Legal business name Fothergill, Russell Eugene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Dec 8th, 2021 - about 4 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 1063472504 NPPES
Texas Other 1659237-01 CSHCN
Texas MEDICAID 1659237-01 CSHCN
Texas Other P00195392 CSHCN
Texas Other 8P1481 CSHCN

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