| Billy D Russom, Dds | |
|
211 Hospital Dr Corning AR 72422-7259 | |
| (870) 857-3557 | |
| (870) 857-5128 |
| Full Name | Billy D Russom, Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 211 Hospital Dr, Corning, Arkansas |
| Authorized Official Name and Position | Renee Hayes (INSURANCE CLERK) |
| Authorized Official Contact | 8708573557 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Billy D Russom, Dds Po Box 435 Corning AR 72422-0435 Ph: (708) 573-5578 | Billy D Russom, Dds 211 Hospital Dr Corning AR 72422-7259 Ph: (870) 857-3557 |
| NPI Number | 1609471499 |
|---|---|
| Provider Enumeration Date | 12/01/2020 |
| Last Update Date | 12/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609471499 | NPI | - | NPPES |
| 1114013067 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
John D Richardson Ii Family Dentistry Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 421 Sw 2nd St, Corning, AR 72422 Phone: 870-857-0045 Fax: 870-857-0051 |