Russell Leon Ingram, MD is a medicare enrolled "Family Medicine" physician in Jacksonville, Alabama. His current practice location is
1460 2nd Ave Sw, Jacksonville, Alabama. You can reach out to his office (for appointments etc.) via phone at
(256) 435-2180.
Russell Leon Ingram is licensed to practice in Alabama (license number 7858) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1639163397.
Physician's Profile
| Full Name | Russell Leon Ingram |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 1460 2nd Ave Sw, Jacksonville, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1639163397
- Provider Enumeration Date: 09/08/2005
- Last Update Date: 07/26/2007
Medicare PECOS Information:
- PECOS PAC ID: 5395631808
- Enrollment ID: I20040223000925
Medical Identifiers
Medical identifiers for Russell Leon Ingram such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1639163397 | NPI | - | NPPES |
| 51519662 | Other | AL | BLUE CROSS BLUE SHIELD |
| 051519662 | Medicaid | AL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 7858 (Alabama) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Russell Leon Ingram is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Russell Leon Ingram, MD 1460 2nd Ave Sw, Jacksonville, AL 36265-3358 Ph: (256) 435-2180 | Russell Leon Ingram, MD 1460 2nd Ave Sw, Jacksonville, AL 36265-3358 Ph: (256) 435-2180 |
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