Russell, John R.
Russell, John R. is an individual health care provider with primary practice located at 2918 Louis Sessions Street , Lake Village AR 71653. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Russell, John R. can be contacted via phone (870) 265-5343.Contact Information
Primary practice address
2918 Louis Sessions Street
Lake Village AR 71653
Phone: (870) 265-5343
Fax: (870) 265-5686
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C4971 | Arkansas |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | C4971 | Arkansas |
Profile Details
| NPI number | 1952380651 |
|---|---|
| LBN Legal business name | Russell, John R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Jan 20th, 2016 - about 9 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 | 1952380651 | NPPES |
| Arkansas | MEDICAID | 101410001 |
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