Smith, Russell Burton

Smith, Russell Burton is an individual health care provider with primary practice located at 1301 Palm Ave , Jacksonville FL 32207-8432. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Smith, Russell Burton can be contacted via phone (904) 202-7300.

Contact Information

Primary practice address
1301 Palm Ave Jacksonville FL 32207-8432
Phone: (904) 202-7300
Fax: (904) 202-7433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 24197 Nebraska
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X ME134346 Florida
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X ME134346 Florida

Profile Details

NPI number 1134112261
LBN Legal business name Smith, Russell Burton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Apr 21st, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134112261 NPPES
Nebraska MEDICAID 10025044400
Nebraska MEDICAID 1134112261
Nebraska MEDICAID 0212142
Nebraska MEDICAID 47078557504
Nebraska Other 19770

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