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General NPI Number Information
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NPI Number | 1750383519
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Entity Type | Organization
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Legal Business Name | DRS RUSSELL BERKEBILE AND ASSOCIATES INC
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 272 BENEDICT AVE
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City | NORWALK
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State | OH
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Zip | 44857-2374
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Country | US
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Telephone | 419-734-3131
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Fax | 706-653-0615
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Provider Business Mailing Address
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Address Line | PO BOX 678950
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City | DALLAS
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State | TX
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Zip | 75267-8950
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Country | US
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Telephone | 800-841-4236
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Fax | 706-653-0615
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Authorized Official
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Title or Position | CEO
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Name | MR. DARIN WISWELL
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Credential |
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Telephone | 440-989-4480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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