Russell-Jenkins, Shane B
Russell-Jenkins, Shane B is an individual health care provider with primary practice located at 2555 E Gila Ridge Rd , Yuma AZ 85365-2240. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Russell-Jenkins, Shane B can be contacted via phone (928) 317-9972.Contact Information
Primary practice address
2555 E Gila Ridge Rd
Yuma AZ 85365-2240
Phone: (928) 317-9972
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | MD2004-0132 | New Mexico |
Profile Details
| NPI number | 1508978750 |
|---|---|
| LBN Legal business name | Russell-Jenkins, Shane B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Sep 9th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508978750 | NPPES |
| New Mexico | MEDICAID | 77456581 |
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