Russell, Debra Kaye

Russell, Debra Kaye is an individual health care provider with primary practice located at 1001 Towson Ave , Fort Smith AR 72901-4921. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Russell, Debra Kaye can be contacted via phone (479) 441-4000.

Contact Information

Primary practice address
1001 Towson Ave Fort Smith AR 72901-4921
Phone: (479) 441-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 20630 Oklahoma
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E1315 Arkansas

Profile Details

NPI number 1730159914
LBN Legal business name Russell, Debra Kaye
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Apr 30th, 2019 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1730159914 NPPES
Oklahoma MEDICAID 100077300A
Oklahoma MEDICAID 134580001

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