Individual
DR. RUSSELL E. BELENCHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
24345 HIGHWAY 15, UNION, MS 39365-8575
(601) 774-8211
(601) 774-8589
Mailing address
PO BOX 2106, MERIDIAN, MS 39302-2106
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10063
MS
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
10063
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115507
—
MS
01
—
080168657
RAILROAD MEDICARE
—
Enumeration date
11/17/2005
Last updated
11/07/2013
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