Healthcare Provider Details

I. General information

NPI: 1255535258
Provider Name (Legal Business Name): RUSSELL J. BARONE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 5TH AVE W
HENDERSONVILLE NC
28739-4206
US

IV. Provider business mailing address

600 5TH AVE W
HENDERSONVILLE NC
28739-4263
US

V. Phone/Fax

Practice location:
  • Phone: 828-697-1343
  • Fax: 828-697-3224
Mailing address:
  • Phone: 828-697-1343
  • Fax: 828-697-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number125
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: