Jayne, Russell P

Jayne, Russell P is an individual health care provider with primary practice located at 6839 W Charleston Blvd , Las Vegas NV 89117-1635. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Jayne, Russell P can be contacted via phone (702) 737-7258.

Contact Information

Primary practice address
6839 W Charleston Blvd Las Vegas NV 89117-1635
Fax: (702) 454-7258
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 9106 Nevada
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 9106 Nevada

Profile Details

NPI number 1689671687
LBN Legal business name Jayne, Russell P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Feb 16th, 2023 - about last year

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 1689671687 NPPES
Nevada Other P00061198 RAILROAD MEDICARE
Nevada MEDICAID 002018156 RAILROAD MEDICARE

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