Russell, Laine C

Russell, Laine C is an individual health care provider with primary practice located at 407 S Medical Arts Ct Suite F, Gillette WY 82716-3372. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Russell, Laine C can be contacted via phone (307) 682-1441.

Contact Information

Primary practice address
407 S Medical Arts Ct Suite F Gillette WY 82716-3372
Phone: (307) 682-1441
Fax: (307) 686-3619
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 6623A Wyoming

Profile Details

NPI number 1578552444
LBN Legal business name Russell, Laine C
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Jan 2nd, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578552444 NPPES
Montana MEDICAID 0078812
Montana Other 312895
Montana Other P00140483

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