| Russell Scott Holliday, DO | |
|
130 Division St, Derby, CT 06418-1326 | |
| (203) 732-7403 | |
| Not Available |
| Full Name | Russell Scott Holliday |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 130 Division St, Derby, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598884900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 043634 (Connecticut) | Primary |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Entity Name | St Lukes Clinic - Wood River Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972891604 PECOS PAC ID: 3173783818 Enrollment ID: O20120404000474 |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Scott Holliday, DO 130 Division St, Derby, CT 06418-1326 Ph: () - | Russell Scott Holliday, DO 130 Division St, Derby, CT 06418-1326 Ph: (203) 732-7403 |
Dr. Sybil Cheng, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-7403 Fax: 203-732-7177 | |
Dr. Gregory Boris, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-7403 Fax: 203-732-7177 | |
Dr. Stephen Michael Kelly, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-735-7421 | |
Laura Butler, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-735-7421 | |
Shane Leslie Leighton, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-735-7421 | |
Dr. Jeanne Kuslis, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-7403 Fax: 203-732-7177 |