Luellen, John Russell
Luellen, John Russell is an individual health care provider with primary practice located at 1000 Dutch Ridge Rd , Beaver PA 15009-9727. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Luellen, John Russell can be contacted via phone (724) 773-3418.Contact Information
Primary practice address
1000 Dutch Ridge Rd
Beaver PA 15009-9727
Phone: (724) 773-3418
Fax: (724) 773-4648
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD065589L | Pennsylvania |
Profile Details
| NPI number | 1609873181 |
|---|---|
| LBN Legal business name | Luellen, John Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Apr 29th, 2008 - about 16 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 | 1609873181 | NPPES |
| Pennsylvania | MEDICAID | 0017116600001 | |
| Pennsylvania | MEDICAID | 0017116600011 | |
| Pennsylvania | MEDICAID | 2229190 |
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