Johnson, Russell
Johnson, Russell is an individual health care provider with primary practice located at 601 Old Wagner Rd Suite 101, Petersburg VA 23805-9313. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Johnson, Russell can be contacted via phone (804) 524-2260.Contact Information
Primary practice address
601 Old Wagner Rd Suite 101
Petersburg VA 23805-9313
Phone: (804) 524-2260
Fax: (804) 524-0096
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 0101045410 | Virginia |
Profile Details
NPI number | 1447205554 |
---|---|
LBN Legal business name | Johnson, Russell |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 24th, 2006 |
Last updated | Jul 7th, 2016 - about 9 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 | 1447205554 | NPPES |
Virginia | Other | 194501 | ANTHEM |
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