Russell, William M.

Russell, William M. is an individual health care provider with primary practice located at 1310 Las Tablas Rd Suite 103, Templeton CA 93465-9737. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Russell, William M. can be contacted via phone (805) 461-7080.

Contact Information

Primary practice address
1310 Las Tablas Rd Suite 103 Templeton CA 93465-9737
Phone: (805) 461-7080
Fax: (805) 464-0243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G37912 California

Profile Details

NPI number 1104892454
LBN Legal business name Russell, William M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Sep 29th, 2011 - 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 1104892454 NPPES
California MEDICAID 00G379120

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