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RUSSELL W COURNOYER JR, DPM – NPI #1427030378
Surgery, Foot & Ankle

NPI Profile for RUSSELL W COURNOYER JR in WORCESTER, MA.

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Contact Information

RUSSELL W COURNOYER JR, DPM
5 NEPONSET ST
WORCESTER, MA  01606-2714
 Phone: 508-856-9181
 Fax: 508-425-6177
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

 213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for RUSSELL W COURNOYER JR · (Male)

NPI Number 1427030378
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 11/16/2005
Last updated 09/26/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 1767
  • Other 7042342 AETNA/US HEALTHCARE
  • Other Y70910 BLUE CARE ELECT
  • Other Y70910 BLUE SHIELD HMO BLUE
  • Other Y70910 BLUE SHIELD INDEMNITY
  • Other 26734 CHILDRENS MED SECURITY PL
  • Other 4886875 CIGNA PAL ID
  • Other 9900050 FALLON COMMUNITY HLTH PL
  • Other 965657 FIRST HEALTH
  • Other AA2838 HARVARD PILGRIM HEALTHCAR
  • Other 26734 HEALTHY START
  • Other 0362093 MEDICAID/WELFARE
  • Other Y70847 MEDICARE B
  • Other 785949 MVP HEALTH CARE
  • Other 042472266 ONE HEALTH PLAN
  • Other 042472266 PRIVATE HEALTHCARE SYSTEM
  • Other 480026268 RAILROAD MEDICARE
  • Other 042472266 THREE RIVERS
  • Other 042472266 TRICARE/CHAMPUS
Hospital affiliation(s)
  • ST VINCENT HOSPITAL - (Acute Care)
    123 SUMMER STREET
    WORCESTER, MA 01608
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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