Dr Tasha M Russell, DO | |
64 Kirk Plz, Inez, KY 41224 | |
(606) 298-2520 | |
(606) 298-2522 |
Full Name | Dr Tasha M Russell |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 64 Kirk Plz, Inez, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780977389 | NPI | - | NPPES |
7100248940 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 03700 (Kentucky) | Primary |
Entity Name | Big Sandy Health Care, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104055805 PECOS PAC ID: 1951211218 Enrollment ID: O20040510000841 |
Entity Name | Albaree Health Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730232182 PECOS PAC ID: 5991735391 Enrollment ID: O20050816000475 |
Entity Name | Eastern Kentucky Tender Care Pediatrics, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043437254 PECOS PAC ID: 9537264262 Enrollment ID: O20110311000572 |
Entity Name | Martin County Rural Health Clinic Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316363112 PECOS PAC ID: 9436372141 Enrollment ID: O20160310000709 |
Entity Name | Frontier Medical Associates Of Paintsville Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568070142 PECOS PAC ID: 2961820337 Enrollment ID: O20200916002859 |
Mailing Address | Practice Location Address |
---|---|
Dr Tasha M Russell, DO Po Box 697, Prestonsburg, KY 41653-0697 Ph: (606) 298-2520 | Dr Tasha M Russell, DO 64 Kirk Plz, Inez, KY 41224 Ph: (606) 298-2520 |