Russell, John Michael
Russell, John Michael is an sole proprietor health care provider with primary practice located at 315 Palm Coast Pkwy Ne Suite 3, Palm Coast FL 32137-3888. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Russell, John Michael can be contacted via phone (386) 447-4440.Contact Information
Primary practice address
315 Palm Coast Pkwy Ne Suite 3
Palm Coast FL 32137-3888
Phone: (386) 447-4440
Fax: (386) 447-4446
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME57356 | Florida |
Profile Details
| NPI number | 1629061189 |
|---|---|
| LBN Legal business name | Russell, John Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Aug 22nd, 2007 - about 17 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 | 1629061189 | NPPES |
| Florida | MEDICAID | 252330200 |
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