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Contact Information

DOUGLAS B RUSSELL, PA
439 US HWY 158 WEST
YANCEYVILLE, NC27379
 Phone: 336-694-1181
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DOUGLAS B RUSSELL · (Male)

NPI Number 1487617619
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 04/10/2006
Last updated 10/05/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 103359
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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