Russell, Tyler Joseph

Russell, Tyler Joseph is an individual health care provider with primary practice located at 2403 Indiana Ave , Fort Campbell KY 42223-5314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Russell, Tyler Joseph can be contacted via phone (270) 412-5114.

Contact Information

Primary practice address
2403 Indiana Ave Fort Campbell KY 42223-5314
Phone: (270) 412-5114
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X OS16674 Florida

Profile Details

NPI number 1699278101
LBN Legal business name Russell, Tyler Joseph
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2018
Last updated May 3rd, 2023 - about 2 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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