Tyler Joseph Russell, is a
Physical Medicine & Rehabilitation physician based in Fort Campbell, Kentucky. Tyler Joseph Russell is licensed to practice in Florida (license number OS16674) and his current practice location is 2403 Indiana Ave, Fort Campbell, Kentucky. He can be reached at his office (for appointments etc.) via phone at
(270) 412-5114.
NPI number for Tyler Joseph Russell is 1699278101 and his current mailing address is 8901 Wisconsin Ave, Bethesda, Maryland. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1699278101.
Physician's Profile
| Full Name | Tyler Joseph Russell |
|---|
| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 2403 Indiana Ave, Fort Campbell, Kentucky |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1699278101
- Provider Enumeration Date: 03/10/2018
- Last Update Date: 05/03/2023
Medical Identifiers
Medical identifiers for Tyler Joseph Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699278101 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | OS16674 (Florida) | 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. Tyler Joseph Russell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tyler Joseph Russell,
8901 Wisconsin Ave,
Bethesda, MD 20889-0004
Ph: () - | Tyler Joseph Russell,
2403 Indiana Ave,
Fort Campbell, KY 42223-5314
Ph: (270) 412-5114 |
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