Radican, Russell D.

Radican, Russell D. is an individual health care provider with primary practice located at 6100 Primacy Pkwy Suite 105, Memphis TN 38119-0705. He recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Sports Physician, Chiropractic Providers / Occupational Health, Chiropractic Providers / Orthopedic. Chiropractic Providers / Sports Physician is his primary health care specialty. Radican, Russell D. can be contacted via phone (901) 682-5335.

Contact Information

Primary practice address
6100 Primacy Pkwy Suite 105 Memphis TN 38119-0705
Phone: (901) 682-5335
Fax: (901) 682-5440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X DC1171 Tennessee
Chiropractic Providers / Occupational Health 111NX0100X DC1171 Tennessee
Chiropractic Providers / Orthopedic 111NX0800X DC1171 Tennessee

Profile Details

NPI number 1528172368
LBN Legal business name Radican, Russell D.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528172368 NPPES
Tennessee Other 61387800-03 CIGNA
Tennessee Other 5829049 CIGNA
Tennessee Other 61387800-04 CIGNA
Tennessee Other 3009201 CIGNA

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