Individual
DR. RUSSELL KING HELTSLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2425 SCOTTSVILLE RD, SUITE #114, BOWLING GREEN, KY 42104-4457
(270) 846-2500
(270) 846-0608
Mailing address
2425 SCOTTSVILLE RD, SUITE #114, BOWLING GREEN, KY 42104-4457
(270) 846-2500
(270) 846-0608
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1216 DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77012169
—
KY
Enumeration date
10/25/2006
Last updated
04/11/2008
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