Russell, Mark S

Russell, Mark S is an individual health care provider with primary practice located at 3633 Central Avenue Suite D, Hot Springs AR 71913-6475. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Russell, Mark S can be contacted via phone (501) 623-6693.

Contact Information

Primary practice address
3633 Central Avenue Suite D Hot Springs AR 71913-6475
Phone: (501) 623-6693
Fax: (501) 623-9403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X C6875 Arkansas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X C-6875 Arkansas
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X C-6875 Arkansas

Profile Details

NPI number 1982694428
LBN Legal business name Russell, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Mar 7th, 2023 - about last year

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 1982694428 NPPES
Arkansas MEDICAID 110923001
Arkansas Other 546256799
Arkansas Other C6875

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