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Contact Information

DAVID R RUSSELL OD
720 6TH ST
EVANSTON, WY82930
 Phone: 307-789-1500
 Fax: 307-789-0077
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for DAVID R RUSSELL OD · (Female)

NPI Number 1700076643
Status Active
Credentials
Entity Individual
Enumeration date 07/26/2007
Last updated 08/02/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • WY License # 293T
  • WY Medicaid 121954500
Hospital affiliation(s) Not Available
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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