Proctor, Russell J
Proctor, Russell J is an individual health care provider with primary practice located at 1711 N Mckenzie St Ste 102 , Foley AL 36535-2282. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Proctor, Russell J can be contacted via phone (251) 952-6653.Contact Information
Primary practice address
1711 N Mckenzie St Ste 102
Foley AL 36535-2282
Phone: (251) 952-6653
Fax: (251) 952-6651
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 18875 | Alabama |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 18875 | Alabama |
Profile Details
| NPI number | 1962511790 |
|---|---|
| LBN Legal business name | Proctor, Russell J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Aug 12th, 2022 - about 3 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 | 1962511790 | NPPES |
| Alabama | MEDICAID | 253180 | |
| Alabama | MEDICAID | 253177 |
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