Mcclellan, Russell L

Mcclellan, Russell L is an individual health care provider with primary practice located at 3000 Herring Avenue , Waco TX 76708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mcclellan, Russell L can be contacted via phone (254) 202-2000.

Contact Information

Primary practice address
3000 Herring Avenue Waco TX 76708
Fax: (254) 753-6229
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G8913 Texas

Profile Details

NPI number 1679507768
LBN Legal business name Mcclellan, Russell L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated May 14th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1679507768 NPPES
Texas MEDICAID 102370701
Texas MEDICAID 102370703

Popular Providers