Dr Jill M Russom, MD | |
12586 Avenue, Orosi, CA 93647-9454 | |
(559) 528-2804 | |
(559) 528-7623 |
Full Name | Dr Jill M Russom |
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Gender | Female |
Speciality | Family Medicine |
Location | 12586 Avenue, Orosi, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639140791 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A71632 (California) | Primary |
Entity Name | Community Foundation Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811258510 PECOS PAC ID: 0345406294 Enrollment ID: O20120723000387 |
Mailing Address | Practice Location Address |
---|---|
Dr Jill M Russom, MD 305 East Center Ave., Visalia, CA 93291-6331 Ph: (559) 737-4700 | Dr Jill M Russom, MD 12586 Avenue, Orosi, CA 93647-9454 Ph: (559) 528-2804 |
Oksana Geletyuk, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 12586 Avenue 408, Orosi, CA 93647 Phone: 877-960-3426 | |
Dr. Hugo Ernesto Lopez Mendoza, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 41696 Road 128, Orosi, CA 93647 Phone: 559-528-6966 Fax: 559-528-3665 | |
Dr. Alberto Ruvalcaba, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 12586 Avenue 408, Orosi, CA 93647 Phone: 877-960-3426 Fax: 559-737-4931 |