Russell John Ellicott in Martinez - Podiatrist
Russell John Ellicott - NPI 1720022452
Russell John Ellicott is a Podiatrist in Martinez, Georgia. Russell John Ellicott practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Russell John Ellicott is 1720022452. The last update date is 2019-02-06.
Russell John Ellicott's current location address is 501 Fury's Ferry Road, Martinez, Georgia. You can contact this provider via phone number 7067383298 and fax number 7063644290. The mailing address for Russell John Ellicott is 501 Fury's Ferry Road, Martinez, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Russell John Ellicott |
|---|---|
| Address | 501 Fury's Ferry Road, Martinez, Georgia |
| Phone Number | 7067383298 |
| Fax Number | 7063644290 |
| Sole Proprietor | Y |
| Credentials | D.P.M. |
NPI Number Detail
| NPI Number | 1720022452 |
|---|---|
| Provider Enumeration Date | 2006-06-15 |
| Last Updated Date | 2019-02-06 |
Provider Mailing Address Detail
| Address | 501 Fury's Ferry Road |
|---|---|
| City | Martinez |
| State | Georgia (GA) |
| Post Code | 30907 |
| Phone Number | 7067383298 |
| Fax Number | 7063644290 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | 96 |
|
Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00336124A | GA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Russell John Ellicott by the Centers for Medicare & Medicaid Services?
The Russell John Ellicott has been assigned the NPI (National Provider Identifier) 1720022452. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Russell John Ellicott located?
The Russell John Ellicott is located at 501 Fury'S Ferry Road, Martinez, GA 30907.
What is Russell John Ellicott's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Russell John Ellicott's specialized field of practice is Podiatrist, and the corresponding taxonomy code that categorizes this area of specialization is 213E00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1720022452 to Russell John Ellicott?
The Russell John Ellicott received its 1720022452 assignment from the Centers for Medicare & Medicaid Services on 2006-06-15.
When was the information regarding Russell John Ellicott most recently updated?
The details pertaining to the Russell John Ellicott, including its address, specialty, and other relevant information, were last refreshed on 2019-02-06.
NPI Number: 1225033541
Address: 261 Old York Rd, Jenkintown, PA