Russo, Anthony Leonard

Russo, Anthony Leonard is an individual health care provider with primary practice located at 750 N Syringa St Ste 100 , Post Falls ID 83854-5275. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Russo, Anthony Leonard can be contacted via phone (208) 262-2600.

Contact Information

Primary practice address
750 N Syringa St Ste 100 Post Falls ID 83854-5275
Phone: (208) 262-2600
Fax: (208) 262-2700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD61084253 Washington
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X M-8310 Idaho

Profile Details

NPI number 1144213455
LBN Legal business name Russo, Anthony Leonard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Nov 4th, 2021 - about 3 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 1144213455 NPPES
Idaho MEDICAID 1144213455
Idaho MEDICAID 2106800

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