Organization
LONESOME PINE ORTHOPAEDICS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D RUSS M.D. (OWNER/ PROVIDER)
(276) 679-1006
Entity
Organization
Contact information
Practice address
767 WOOD AVE E, BIG STONE GAP, VA 24219-3023
(276) 523-1006
(276) 523-5293
Mailing address
PO BOX 857, BIG STONE GAP, VA 24219-0857
(276) 523-1006
(276) 523-5293
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65943912
—
KY
Enumeration date
05/26/2006
Last updated
03/30/2009
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