Hardy, Russell
Hardy, Russell is an individual health care provider with primary practice located at 260 Hospital Dr Suite 103, Ukiah CA 95482-4533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Hardy, Russell can be contacted via phone (707) 463-8000.Contact Information
Primary practice address
260 Hospital Dr Suite 103
Ukiah CA 95482-4533
Phone: (707) 463-8000
Fax: (707) 462-1111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G59375 | California |
Profile Details
| NPI number | 1558345348 |
|---|---|
| LBN Legal business name | Hardy, Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Jun 14th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558345348 | NPPES |
| California | MEDICAID | 00G593750 |
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