Provider Demographics
NPI:1255449534
Name:RUSSELL J BARONE DPM PA
Entity type:Organization
Organization Name:RUSSELL J BARONE DPM PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:BARONE
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:828-697-1343
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:28739-4263
Practice Address - Country:US
Practice Address - Phone:828-697-1343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08009OtherBCBS OF N CAROLINA
NC8908009Medicaid
NC8908009Medicaid
NC8908009Medicaid
NC243060AMedicare PIN
NC5551490001Medicare NSC