Healthcare Provider Details

I. General information

NPI: 1255449534
Provider Name (Legal Business Name): RUSSELL J BARONE DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 11/05/2023
Certification Date: 11/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 5TH AVE W
HENDERSONVILLE NC
28739-4263
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:
Mailing address:
  • Phone: 828-697-1343
  • Fax: 828-697-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: PAMELA BARONE STOVER
Title or Position: PRESIDENT
Credential: DPM
Phone: 828-697-1343