Gornichec, Russell S

Gornichec, Russell S is an sole proprietor health care provider with primary practice located at 501 W Grand Ave , Hot Springs AR 71901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gornichec, Russell S can be contacted via phone (501) 781-0772.

Contact Information

Primary practice address
501 W Grand Ave Hot Springs AR 71901
Phone: (501) 781-0772
Fax: (501) 781-4000
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X E7873 Arkansas
Allopathic & Osteopathic Physicians / Surgery 208600000X 21488 Oklahoma
Allopathic & Osteopathic Physicians / Surgery 208600000X 01077212A Indiana

Profile Details

NPI number 1437121860
LBN Legal business name Gornichec, Russell S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2006
Last updated Jan 6th, 2021 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1437121860 NPPES
Indiana Other 7008146 AETNA
Indiana Other 1021531 AETNA
Indiana MEDICAID 201233001 AETNA
Indiana Other 50113964 AETNA
Indiana Other P00013588 AETNA
Indiana MEDICAID 100827130B AETNA

Popular Providers