Russell, Byron Dale
Russell, Byron Dale is an individual health care provider with primary practice located at 907 Georgiana St , Port Angeles WA 98362-3911. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Russell, Byron Dale can be contacted via phone (360) 565-0999.Contact Information
Primary practice address
907 Georgiana St
Port Angeles WA 98362-3911
Phone: (360) 565-0999
Fax: (360) 565-9251
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD00025573 | Washington |
Profile Details
| NPI number | 1043215809 |
|---|---|
| LBN Legal business name | Russell, Byron Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Jul 19th, 2017 - about 8 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 | 1043215809 | NPPES |
| Arizona | MEDICAID | 561060 |
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