Billy Dale Russom, DDS is a medicare enrolled "Dentist - General Practice" provider in Corning, Arkansas. His current practice location is
211 Hospital Dr, Corning, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 857-3557.
Billy Dale Russom is licensed to practice in Arkansas (license number AR2169) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114013067.
Healthcare Provider's Profile
Full Name | Billy Dale Russom |
---|
Gender | Male |
---|
Speciality | Dentist - General Practice |
---|
Location | 211 Hospital Dr, Corning, Arkansas |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1114013067
- Provider Enumeration Date: 10/05/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 1557660636
- Enrollment ID: I20160422002059
Medical Identifiers
Medical identifiers for Billy Dale Russom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1114013067 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | AR2169 (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Billy Dale Russom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Billy Dale Russom, DDS Po Box 435, Corning, AR 72422-0435 Ph: (870) 857-3557 | Billy Dale Russom, DDS 211 Hospital Dr, Corning, AR 72422-7259 Ph: (870) 857-3557 |
Reviews and Comments