Russell, Jacob Robert

Russell, Jacob Robert is an individual health care provider with primary practice located at 16815 W Bell Rd , Surprise AZ 85374-2101. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Russell, Jacob Robert can be contacted via phone (602) 833-6900.

Contact Information

Primary practice address
16815 W Bell Rd Surprise AZ 85374-2101
Phone: (602) 833-6900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 3749 Michigan
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 008645 Arizona

Profile Details

NPI number 1417318361
LBN Legal business name Russell, Jacob Robert
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 18th, 2016
Last updated Jul 8th, 2022 - about 2 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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