Travis Ray Russell, DDS is a
Dentist based in Mc Kenzie, Tennessee. Travis Ray Russell is licensed to practice in Tennessee (license number 10509) and his current practice location is
594 Main St N, Mc Kenzie, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(731) 415-3084.
NPI number for Travis Ray Russell is 1679001085 and his current mailing address is 594 Main St N, Mc Kenzie, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679001085.
Healthcare Provider's Profile
| Full Name | Travis Ray Russell |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
|---|
| Location | 594 Main St N, Mc Kenzie, Tennessee |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1679001085
- Provider Enumeration Date: 05/30/2017
- Last Update Date: 05/30/2017
Medical Identifiers
Medical identifiers for Travis Ray Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679001085 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 10509 (Tennessee) | 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. Travis Ray Russell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Travis Ray Russell, DDS
594 Main St N,
Mc Kenzie, TN 38201-1707
Ph: () - | Travis Ray Russell, DDS
594 Main St N,
Mc Kenzie, TN 38201-1707
Ph: (731) 415-3084 |
Reviews and Comments