Wheatley, Russell H

Wheatley, Russell H is an individual health care provider with primary practice located at 3099 Aloma Ave , Winter Park FL 32792-3702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wheatley, Russell H can be contacted via phone (407) 677-1140.

Contact Information

Primary practice address
3099 Aloma Ave Winter Park FL 32792-3702
Phone: (407) 677-1140
Fax: (407) 677-5841
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS5336 Florida

Profile Details

NPI number 1366490948
LBN Legal business name Wheatley, Russell H
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Nov 6th, 2014 - about 10 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 1366490948 NPPES
Florida MEDICAID 27136200
Florida Other 80173

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