Douglas Blane Russell, PA is a medicare enrolled "Physician Assistant" in Yanceyville, North Carolina. His current practice location is
439 Us Hwy 158 West, Yanceyville, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(336) 694-1181.
Douglas Blane Russell is licensed to practice in North Carolina (license number 103359) 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 1487617619.
Provider's Profile
Full Name | Douglas Blane Russell |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 439 Us Hwy 158 West, Yanceyville, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487617619
- Provider Enumeration Date: 04/10/2006
- Last Update Date: 10/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 3274521356
- Enrollment ID: I20040505001660
Medical Identifiers
Medical identifiers for Douglas Blane Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487617619 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 103359 (North Carolina) | 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. Douglas Blane Russell 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 |
Douglas Blane Russell, PA 5610 Groometown Rd, High Point, High Point, NC 27263-9368 Ph: (336) 688-0928 | Douglas Blane Russell, PA 439 Us Hwy 158 West, Yanceyville, NC 27379 Ph: (336) 694-1181 |
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