Warren, Russell Alan
Warren, Russell Alan is an individual health care provider with primary practice located at 601 W Broad St , Dunn NC 28334-4861. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Warren, Russell Alan can be contacted via phone (910) 892-7197.Contact Information
Primary practice address
601 W Broad St
Dunn NC 28334-4861
Phone: (910) 892-7197
Fax: (910) 892-6507
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1841 | North Carolina |
Profile Details
| NPI number | 1699769752 |
|---|---|
| LBN Legal business name | Warren, Russell Alan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2005 |
| Last updated | Nov 28th, 2011 - about 14 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 | 1699769752 | NPPES |
| North Carolina | MEDICAID | 89093HN | |
| North Carolina | Other | 093HN |
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