Harris, Russell D
Harris, Russell D is an individual health care provider with primary practice located at 2 Saint Vincent Cir , Little Rock AR 72205-5423. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Harris, Russell D can be contacted via phone (501) 664-4532.Contact Information
Primary practice address
2 Saint Vincent Cir
Little Rock AR 72205-5423
Phone: (501) 664-4532
Fax: (501) 663-4335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | C-8325 | Arkansas |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | C-8325 | Arkansas |
Profile Details
| NPI number | 1780670638 |
|---|---|
| LBN Legal business name | Harris, Russell D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2005 |
| Last updated | Mar 17th, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780670638 | NPPES |
| Arkansas | Other | 171973300 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | 55608 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | 050019624 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | 71033532430 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | 770133101 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | 14975000020 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | S03731 | US DEPT. OF LABOR OWCP |
| Arkansas | Other | 050019621 | US DEPT. OF LABOR OWCP |
| Arkansas | MEDICAID | 121599001 | US DEPT. OF LABOR OWCP |
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