Basic Information
| Provider Information | |||||||||
| NPI: | 1598874489 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUSS | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | BARNARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 327 1ST AVE NW | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286016122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286955900 | ||||||||
| FaxNumber: | 8286954256 | ||||||||
| Practice Location | |||||||||
| Address1: | 350 E PARKER RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286555155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286241900 | ||||||||
| FaxNumber: | 8286954256 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 03/28/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 20957 | NC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 494265000 | 01 | NC | MAGELLAN BEHAVIORAL HEALTH | OTHER | 183470 | 01 | NC | MEDCOST | OTHER | REFER TO UBH | 01 | NC | UNITED BEHAVIORAL HEALTH | OTHER | REFER TO EVERCARE | 01 | NC | EVERCARE | OTHER | 2302593 | 01 | NC | CIGNA BEHAVIORAL HEALTH | OTHER | 5900196 | 05 | NC | MEDICAID | 74033 | 01 | NC | BCBS | OTHER |