Russell, Jeffrey W

Russell, Jeffrey W is an individual health care provider with primary practice located at 85 N Grand Ave 2Nd Floor, Fort Thomas KY 41075-1793. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Russell, Jeffrey W can be contacted via phone (859) 781-2628.

Contact Information

Primary practice address
85 N Grand Ave 2Nd Floor Fort Thomas KY 41075-1793
Phone: (859) 781-2628
Fax: (859) 572-4403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35037666R Ohio
Allopathic & Osteopathic Physicians / Surgery 208600000X 21322 Kentucky

Profile Details

NPI number 1659337988
LBN Legal business name Russell, Jeffrey W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Oct 22nd, 2012 - about 12 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 1659337988 NPPES
Kentucky MEDICAID 64213226
Kentucky MEDICAID 2564238

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