Individual
RUSSELL ROBERT JANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 LEMOYNE SQ, SUITE 201, LEMOYNE, PA 17043-1230
(717) 737-4511
(717) 909-6659
Mailing address
1 LEMOYNE SQ, SUITE 201, LEMOYNE, PA 17043-1230
(717) 737-4511
(717) 909-6659
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD028002E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32805
AETNA HMO PROVIDER NUMBER
PA
01
—
4531553
AETNA PPO PROVIDER NUMBER
PA
01
—
50026628
CAPITAL BLUE CROSS
PA
01
—
57617
HIGHMARK BLUE SHIELD
PA
Enumeration date
01/17/2006
Last updated
08/13/2007
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