Individual
MR. LARRY JOE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 BALSAM RD, HENDERSONVILLE, NC 28792-5703
(828) 693-4431
(828) 693-4434
Mailing address
PO BOX 2618, HENDERSONVILLE, NC 28793-2618
(828) 693-4431
(828) 693-4434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9901016
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012U9
BCBS NC
—
01
—
1232Q
BCBS NC
—
01
—
80191107
RR MEDICARE
—
01
—
N01016
SC MEDICAID
—
Enumeration date
12/22/2005
Last updated
08/13/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us