Thomas, William Russell

Thomas, William Russell is an sole proprietor health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-5674. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Thomas, William Russell can be contacted via phone (706) 721-8623.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-5674
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 059218 Georgia

Profile Details

NPI number 1548242357
LBN Legal business name Thomas, William Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 17th, 2005
Last updated Dec 18th, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548242357 NPPES
Georgia Other 59218 GA MEDICAL LICENSE

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