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
Phone: (254) 202-2000
Fax: (254) 753-6229
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1679507768 | NPPES |
Texas | MEDICAID | 102370701 | |
Texas | MEDICAID | 102370703 |
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