Gordon J Russo in Gretna - Procedural Dermatology
Gordon J Russo - NPI 1083612469
Gordon J Russo is a Procedural Dermatology in Gretna, Louisiana. Gordon J Russo practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Gordon J Russo is 1083612469. The last update date is 2010-02-03.
Gordon J Russo's current location address is 120 Meadowcrest St, Gretna, Louisiana. You can contact this provider via phone number 5043917620 and fax number 5043917524. The mailing address for Gordon J Russo is 120 Meadowcrest St, Gretna, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gordon J Russo |
|---|---|
| Address | 120 Meadowcrest St, Gretna, Louisiana |
| Phone Number | 5043917620 |
| Fax Number | 5043917524 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1083612469 |
|---|---|
| Provider Enumeration Date | 2005-07-11 |
| Last Updated Date | 2010-02-03 |
Provider Mailing Address Detail
| Address | 120 Meadowcrest St |
|---|---|
| City | Gretna |
| State | Louisiana (LA) |
| Post Code | 7005652550 |
| Phone Number | 5043917620 |
| Fax Number | 5043917524 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
| Licence No | 15208 |
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Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1329495 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Gordon J Russo by the Centers for Medicare & Medicaid Services?
The Gordon J Russo has been assigned the NPI (National Provider Identifier) 1083612469 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Gordon J Russo is geographically located?
The Gordon J Russo is physically situated at the following location: 120 Meadowcrest St, Gretna, LA, 7005652550.
What is Gordon J Russo's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Gordon J Russo is Procedural Dermatology, and the taxonomy code that classifies this field of practice is 207Ns0135X.
On what date did the Centers for Medicare & Medicaid Services issue the 1083612469 to Gordon J Russo?
The Gordon J Russo received its 1083612469 assignment from the Centers for Medicare & Medicaid Services on 2005-07-11.
As of what date were the details related to Gordon J Russo most recently updated or revised?
The information pertaining to Gordon J Russo, including its address, specialty, and other relevant details, was last updated or revised on 2010-02-03.