Russell, James Patrick

Russell, James Patrick is an individual health care provider with primary practice located at 13800 W North Ave Ste 100, Brookfield WI 53005-4974. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Russell, James Patrick can be contacted via phone (262) 754-4488.

Contact Information

Primary practice address
13800 W North Ave Ste 100 Brookfield WI 53005-4974
Phone: (262) 754-4488
Fax: (262) 754-4940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 47855020 Wisconsin

Profile Details

NPI number 1235122870
LBN Legal business name Russell, James Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Apr 20th, 2008 - about 16 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 1235122870 NPPES
Wisconsin MEDICAID 34688800
Wisconsin Other P00368881
Wisconsin Other P00384061
Wisconsin Other P00364352

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