Hunter, Russell Lanny

Hunter, Russell Lanny is an individual health care provider with primary practice located at 830 Ainsworth Drive , Prescott AZ 86301-1614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Hunter, Russell Lanny can be contacted via phone (928) 776-0325.

Contact Information

Primary practice address
830 Ainsworth Drive Prescott AZ 86301-1614
Fax: (928) 776-0405
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X AZ6167 Arizona
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 6167 Arizona

Profile Details

NPI number 1639385644
LBN Legal business name Hunter, Russell Lanny
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2007
Last updated Feb 27th, 2012 - about 12 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 1639385644 NPPES
Arizona MEDICAID 206781
Arizona Other 6167

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