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Individual

DR. RUSSELL DAVID EARNEST JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1336 ALVERSER PLZ, MIDLOTHIAN, VA 23113-2604
(804) 594-1944
(804) 594-1945
Mailing address
1336 ALVERSER PLZ, MIDLOTHIAN, VA 23113-2604
(804) 594-1944
(804) 594-1945

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103300896
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010049351
VA
01
2126938
MAMSI
VA
01
2139749
FIRST HEALTH
VA
01
232349
SOUTHERN HEALTH
VA
01
3106155
CIGNA
VA
01
389911
ANTHEM
VA
01
605671100
OWCP
VA
01
7797532
AETNA
VA
01
861077371
PHCS
VA
Enumeration date
08/31/2006
Last updated
12/31/2015
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