| Russo Clinic-a Medical Corporation | |
|
1124 7th St Morgan City LA 70380-1951 | |
| (985) 384-1562 | |
| (985) 385-6749 |
| Full Name | Russo Clinic-a Medical Corporation |
|---|---|
| Speciality | Surgery |
| Location | 1124 7th St, Morgan City, Louisiana |
| Authorized Official Name and Position | William H Johnson (DOCTOR/OWNER) |
| Authorized Official Contact | 9853841562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russo Clinic-a Medical Corporation Po Box 2347 Morgan City LA 70381-2347 Ph: (985) 384-1562 | Russo Clinic-a Medical Corporation 1124 7th St Morgan City LA 70380-1951 Ph: (985) 384-1562 |
| NPI Number | 1720070824 |
|---|---|
| Provider Enumeration Date | 08/16/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720070824 | NPI | - | NPPES |
| 1167053 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 12846B (Louisiana) | Primary |
| 207R00000X | Internal Medicine | 016985 (Louisiana) | Primary |
| 208600000X | Surgery | 02397R (Louisiana) | Primary |
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