Albert Russenberger II
Individual provider Active NPI Driver · Cabot, AR
NPI 1760074264 · NPPES record last updated Feb 5, 2021
Key facts
- NPI
- 1760074264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 3148 Highway 367 S
Cabot, AR 72023-7473 - Phone
- (501) 941-3500
- NPI assigned
- Feb 5, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
3148 Highway 367 S
Cabot, AR 72023-7473
Mailing address
3127 Southwest Dr Ste a
Jonesboro, AR 72404-8404
Phone (870) 336-8100
Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.