Anthony P Russo Jr, DO | |
807 W Main St, Wilmington, OH 45177-0868 | |
(937) 382-1864 | |
(937) 382-8917 |
Full Name | Anthony P Russo Jr |
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Gender | Male |
Speciality | Anesthesiology |
Location | 807 W Main St, Wilmington, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558400242 | NPI | - | NPPES |
0589411 | Medicaid | OH | |
000000238391 | Other | OH | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 34007741R (Iowa) | Primary |
Entity Name | Anesthesia Associates Of Savannah ,pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487663688 PECOS PAC ID: 4880689447 Enrollment ID: O20040415000096 |
Entity Name | American Anesthesiology Associates Of Georgia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528068673 PECOS PAC ID: 7618934779 Enrollment ID: O20041210000442 |
Entity Name | Lighthouse Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306036561 PECOS PAC ID: 4082702386 Enrollment ID: O20071121000002 |
Mailing Address | Practice Location Address |
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Anthony P Russo Jr, DO 6605 Abercorn St, Suite 108, Savannah, GA 31405-5815 Ph: (912) 355-7214 | Anthony P Russo Jr, DO 807 W Main St, Wilmington, OH 45177-0868 Ph: (937) 382-1864 |
Connie S Horn, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 807 W Main St, Wilmington, OH 45177 Phone: 937-382-1864 Fax: 937-382-8917 |