Russell, Joy Danae

Russell, Joy Danae is an sole proprietor health care provider with primary practice located at 5701 Brainerd Rd Suite 111, Chattanooga TN 37411-4016. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Russell, Joy Danae can be contacted via phone (423) 521-8605.

Contact Information

Primary practice address
5701 Brainerd Rd Suite 111 Chattanooga TN 37411-4016
Phone: (423) 521-8605
Fax: (423) 521-8607
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 704 Tennessee

Profile Details

NPI number 1215166384
LBN Legal business name Russell, Joy Danae
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 9th, 2009
Last updated Jul 20th, 2012 - about 13 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 1215166384 NPPES
Tennessee Other 9862600 AETNA
Tennessee Other 8069587 AETNA
Tennessee MEDICAID 1520824 AETNA
Tennessee Other 1147592 AETNA
Tennessee Other 4282079 AETNA

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