Russell, Daric J
Russell, Daric J is an sole proprietor health care provider with primary practice located at 3385 Potomac Way , Idaho Falls ID 83404-4978. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Russell, Daric J can be contacted via phone (208) 522-7246.Contact Information
Primary practice address
3385 Potomac Way
Idaho Falls ID 83404-4978
Phone: (208) 522-7246
Fax: (208) 529-2620
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 0-1036 | Idaho |
Profile Details
| NPI number | 1154681633 |
|---|---|
| LBN Legal business name | Russell, Daric J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2012 |
| Last updated | Jan 6th, 2020 - about 5 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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