Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RUSSELL LEON INGRAM, M.D.
Deactivated Sole ProprietorRUSSELL LEON INGRAM, M.D. is a Family Medicine healthcare provider located in JACKSONVILLE, Alabama. NPI 1639163397 is deactivated in the NPPES registry. Verify at CMS.
Family Medicine · JACKSONVILLE, AL
This NPI has been deactivated.
The record was deactivated on March 25, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1639163397
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 8, 2005 (0.54246575342466 yrs)
- Last Updated
- Jul 26, 2007
- Deactivated
- Mar 25, 2006
- License
-
7858 (AL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1460 2ND AVE SWJACKSONVILLE, AL, 362653358Browse AL providers · Browse ZIP 36265
- Phone
- 2564352180
- Fax
- 2564359525
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in JACKSONVILLE, AL
| Name | Credential | NPI |
|---|---|---|
| DR. KEWAL K VERMA | M.D. | 1285802876 |
| BRIAN RUSSELL INGRAM | DO | 1609356039 |
| DR. MORGAN READ MARTIN | MD | 1700464732 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.