National Provider Identifier Database

ERA RUSSELL, HAIR LOSS SPECIALIST – NPI #1447604178
Prosthetist

An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both


Contact Information

ERA RUSSELL, HAIR LOSS SPECIALIST
2170 W POINT RD
SUITE 36
LAGRANGE, GA30240-4007
Phone: 762-323-7874
Fax:
Website:
Specialty Taxonomy Code
* Prosthetist 224P00000X
Orthotics/Prosthetics Fitter 225000000X

* Indicates primary specialty

NPI Profile & details for ERA RUSSELL

NPI Number 1447604178
Credentials HAIR LOSS SPECIALIST
Entity Individual
Enumeration date 04/19/2016
Last updated 11/01/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • GA License #: 224P00000X
  • GA Medicaid: 7708
Hospital affiliation n/a

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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