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Contact Information

WESLEY A RUSSELL, MD
11141 PARKVIEW PLAZA DR STE 110
SUITE 110
FORT WAYNE, IN46845-1714
 Phone: 260-266-9100
 Fax: 260-266-9110
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for WESLEY A RUSSELL · (Male)

NPI # 1508029497
Status Active
Credentials MD
Entity Individual
Enumeration date 07/09/2008
Last updated 06/15/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01072532A
  • IN Medicaid 201163340
  • MI Medicaid 1508029497
  • OH Medicaid 0083773
Hospital affiliation(s)
  • CAMERON MEMORIAL COMMUNITY HOSPITAL INC - (Critical Access)
    416 E MAUMEE ST
    ANGOLA, IN 46703
  • DEKALB HEALTH - (Acute Care)
    1316 E SEVENTH ST
    AUBURN, IN 46706
  • PARKVIEW REGIONAL MEDICAL CENTER - (Acute Care)
    11109 PARKVIEW PLAZA DRIVE
    FORT WAYNE, IN 46845
  • PARKVIEW WHITLEY HOSPITAL - (Acute Care)
    1260 E SR 205
    COLUMBIA CITY, IN 46725
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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