Wardlaw, Russell J

Wardlaw, Russell J is an individual health care provider with primary practice located at 16061 Doctors Blvd Suite B, Hammond LA 70403-1499. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wardlaw, Russell J can be contacted via phone (985) 542-1334.

Contact Information

Primary practice address
16061 Doctors Blvd Suite B Hammond LA 70403-1499
Phone: (985) 542-1334
Fax: (985) 893-9594
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 026005 Louisiana

Profile Details

NPI number 1376734210
LBN Legal business name Wardlaw, Russell J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2007
Last updated Apr 23rd, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1376734210 NPPES
Louisiana MEDICAID 1056529

Popular Providers