Russell, Aaron Jacob

Russell, Aaron Jacob is an individual health care provider with primary practice located at 969 N Mason Rd Div Im Dermatology, Ste 220, Saint Louis MO 63141-6282. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Russell, Aaron Jacob can be contacted via phone (314) 273-3376.

Contact Information

Primary practice address
969 N Mason Rd Div Im Dermatology, Ste 220 Saint Louis MO 63141-6282
Fax: (888) 682-0525
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 2021011092 Missouri
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 2021011092 Missouri

Profile Details

NPI number 1568813863
LBN Legal business name Russell, Aaron Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2016
Last updated Apr 25th, 2024 - about last year

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 1568813863 NPPES
Missouri MEDICAID 200061535

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