Russell, Mary C
Russell, Mary C is an individual health care provider with primary practice located at 1 Medical Village Dr , Edgewood KY 41017-3403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Russell, Mary C can be contacted via phone (859) 301-2160.Contact Information
Primary practice address
1 Medical Village Dr
Edgewood KY 41017-3403
Phone: (859) 301-2160
Fax: (859) 301-3932
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 37282 | Kentucky |
Profile Details
| NPI number | 1841272945 |
|---|---|
| LBN Legal business name | Russell, Mary C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2005 |
| Last updated | Aug 8th, 2013 - about 11 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 | 1841272945 | NPPES |
| Ohio | MEDICAID | 2700732 | |
| Ohio | Other | 300132691 | |
| Ohio | MEDICAID | 64052129 |
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