Provider Demographics
NPI:1255535258
Name:BARONE, RUSSELL J (DPM)
Entity type:Individual
Prefix:
First Name:RUSSELL
Middle Name:J
Last Name:BARONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4263
Mailing Address - Country:US
Mailing Address - Phone:828-697-1343
Mailing Address - Fax:828-697-3224
Practice Address - Street 1:600 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4206
Practice Address - Country:US
Practice Address - Phone:828-697-1343
Practice Address - Fax:828-697-3224
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC125213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08009OtherBCBS OF NC
P00862374OtherMEDICARE RAILROAD
NC56-1514942OtherPRIVATE INSURANCE
P00862374OtherMEDICARE RAILROAD
NC243060AMedicare PIN
T64030Medicare UPIN
NC56-1514942OtherPRIVATE INSURANCE