Russell, Jeremy W
Russell, Jeremy W is an individual health care provider with primary practice located at 3901 Stewart Ave , Wausau WI 54401-3948. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Russell, Jeremy W can be contacted via phone (715) 907-0900.Contact Information
Primary practice address
3901 Stewart Ave
Wausau WI 54401-3948
Phone: (715) 907-0900
Fax: (715) 803-6977
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 55775 | Wisconsin |
Profile Details
| NPI number | 1376756924 |
|---|---|
| LBN Legal business name | Russell, Jeremy W |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2007 |
| Last updated | Mar 14th, 2024 - about 8 months 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 | 1376756924 | NPPES |
| Wisconsin | MEDICAID | 100016494 |
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