RUSSEL T MCKENNA (NPI# 1184633711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184633711 |
| Entity Type | Individual |
| Full Name | RUSSEL T MCKENNA |
| Credential | DO |
| Practice Address |
1325 N 600 E Ste 101 Logan UT 84341 |
| Practice Telephone | 4357505599 |
| Practice Fax Number | 4357500861 |
| Mailing Telephone | 4357505599 |
| Mailing Fax Number | 4357500861 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2851791204 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
1325 N 600 E STE 101 |
| City | LOGAN |
| State | UT |
| Zip Code | 84341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477067775 | Crystal Anne Burtis | Physician Assistant | 1325 N 600 E Ste 101, Logan, UT 84341-6743 | 2017-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124303151 | Samuel P Rojas Md Inc | Pediatrics | 143 1/2 Stollings Ave, Logan, WV 25601-4010 | 2011-10-21 |
| 1043294739 | Okpani Martin Nnachi | Pediatrics | 60 Hospital Dr, Logan, WV 25601-3452 | 2005-12-06 |
| 1053303297 | Mark J Scarmack | Pediatrics | 1383 W Hunter St, Logan, OH 43138-1013 | 2005-08-15 |
| 1427052299 | Bashar F Kayali | Pediatrics | 31480 Chieftain Dr, Suite D, Logan, OH 43138-9000 | 2005-06-09 |
| 1699238436 | Vernon Medical Pllc | Pediatrics | 630 E 1400 N Ste 118, Logan, UT 84341-2691 | 2019-04-09 |
| 1669714341 | Daniel M Sandgren | Pediatrics | 1350 N 500 E, Logan, UT 84341-2400 | 2013-03-20 |
| 1902164338 | Chad William Dallon | Pediatrics | 1350 N 500 E, Logan, UT 84341-2400 | 2012-04-23 |
| 1780811075 | Matt N Rogers | Pediatrics | 1350 N 500 E, Logan, UT 84341-2400 | 2009-06-15 |
| 1184803827 | Ryan R Bell | Pediatrics | 1325 N 600 E, Suite 101, Logan, UT 84341-6738 | 2007-10-30 |
| 1114112026 | Jian Kang | Pediatrics | 20 Hospital Dr, Logan, WV 25601-3452 | 2007-09-13 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.