Thomas, Dennis Russell
Thomas, Dennis Russell is an individual health care provider with primary practice located at 4370 Kings Way , Valdosta GA 31602-6904. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Thomas, Dennis Russell can be contacted via phone (229) 433-8181.Contact Information
Primary practice address
4370 Kings Way
Valdosta GA 31602-6904
Phone: (229) 433-8181
Fax: (229) 293-7801
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 022898 | Georgia |
Profile Details
NPI number | 1821031329 |
---|---|
LBN Legal business name | Thomas, Dennis Russell |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 13th, 2006 |
Last updated | Nov 6th, 2020 - about 5 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 | 1821031329 | NPPES |
Georgia | MEDICAID | 117939 | |
Georgia | MEDICAID | 000260809E | |
Georgia | MEDICAID | 336042 |
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