Russell, Andrew
Russell, Andrew is an individual health care provider with primary practice located at 925 2Nd Ave , Monte Vista CO 81144-1432. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Russell, Andrew can be contacted via phone (719) 852-2512.Contact Information
Primary practice address
925 2Nd Ave
Monte Vista CO 81144-1432
Phone: (719) 852-2512
Fax: (719) 852-3923
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | New Mexico | |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0068003 | Colorado |
Profile Details
| NPI number | 1669869558 |
|---|---|
| LBN Legal business name | Russell, Andrew |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2015 |
| Last updated | Mar 8th, 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 | 1669869558 | NPPES |
| Colorado | Other | 0068003 | LICENSURE |
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