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General NPI Number Information
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NPI Number | 1407868722
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Entity Type | Individual
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Provider Name | RUSSELL JAMES PIKUS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 225 S PINE ST JMB 2ND FLOOR
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City | SEYMOUR
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State | IN
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Zip | 47274
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Country | US
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Telephone | 812-523-4860
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Fax | 812-523-4839
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Provider Business Mailing Address
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Address Line | 225 S PINE ST JMB 2ND FLOOR
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City | SEYMOUR
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State | IN
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Zip | 47274
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Country | US
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Telephone | 812-523-4860
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Fax | 812-523-4839
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 01040449A
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License Number State | IN
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