Russell, Bruce Lynn

Russell, Bruce Lynn is an individual health care provider with primary practice located at 600 Cut Off Rd Suite 14, Port Aransas TX 78373-4245. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Russell, Bruce Lynn can be contacted via phone (361) 749-1930.

Contact Information

Primary practice address
600 Cut Off Rd Suite 14 Port Aransas TX 78373-4245
Phone: (361) 749-1930
Fax: (361) 749-1933
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X G8391 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 187912 New York

Profile Details

NPI number 1336134188
LBN Legal business name Russell, Bruce Lynn
Credentials M.D. PLLC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Nov 25th, 2014 - about 11 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 1336134188 NPPES
New York MEDICAID 01276695
New York MEDICAID 1821670-01

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