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Dr. Lincoln David Russin, MD
Specialist in Jackson, California
NPI 1548308273

Lincoln David Russin is a Specialist based in Jackson, CA. Lincoln David Russin practices in Jackson, CA and has the professional credentials of MD. The NPI Number for Lincoln David Russin is 1548308273 and holds a License No. G86200 (California).

The current practice location address for Lincoln David Russin is 200 Mission Blvd, Jackson, CA and can be reached out via phone at 209-223-0949 and via fax at 209-223-0965.

Location: 200 Mission Blvd, Jackson, CA, 95642-0877
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548308273
Provider Name
Lincoln David Russin
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
200 Mission Blvd, Jackson, CA, 95642-0877
Phone Number
209-223-0949
Fax Number
209-223-0965
Provider Enumeration Date
02/02/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0043480 05 CA
institution
Provider Business Practice Location Address Details
Address
200 Mission Blvd
City
Jackson
State
California
Zip
95642-2564
Phone Number
209-223-0949
Fax Number
209-223-0965
person
Provider Business Mailing Address Details
Address
200 Mission Blvd
City
Jackson
State
California
Zip
95642-2564
Phone Number
209-223-0949
Fax Number
209-223-0965
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G86200 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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