Lolley, Russell T

Lolley, Russell T is an individual health care provider with primary practice located at 102 Thomas Rd., Ste 201 , West Monroe LA 71291-5547. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Lolley, Russell T can be contacted via phone (318) 329-8411.

Contact Information

Primary practice address
102 Thomas Rd., Ste 201 West Monroe LA 71291-5547
Phone: (318) 329-8411
Fax: (318) 329-8412
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 010612 Louisiana
Allopathic & Osteopathic Physicians / Surgery 208600000X MD.010612 Louisiana

Profile Details

NPI number 1356378590
LBN Legal business name Lolley, Russell T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated May 8th, 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 1356378590 NPPES
Louisiana MEDICAID 1136361

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