Russell Dermatology of Conway, PLLC
NPI 1639134067 · Dermatology Physician · Conway, AR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Russell Dermatology of Conway, PLLC is a Dermatology Physician organization in Conway, AR (NPI 1639134067).
Provider details
- NPI number
- 1639134067
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jackie Russell, Bus/Office Mgr(501) 328-5050
- License
- E1574 (AR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-04-19
- Last updated
- 2025-10-09
- Certified
- 2025-10-09
Frequently asked questions
- What is Russell Dermatology of Conway, PLLC's NPI number?
- Russell Dermatology of Conway, PLLC's National Provider Identifier (NPI) is 1639134067, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Russell Dermatology of Conway, PLLC?
- Russell Dermatology of Conway, PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Russell Dermatology of Conway, PLLC located?
- Russell Dermatology of Conway, PLLC's practice location on file with NPPES is 2425 Dave Ward Dr, Conway, AR 72034-8686.
- What is Russell Dermatology of Conway, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Russell Dermatology of Conway, PLLC is (501) 328-5050.
- Does Russell Dermatology of Conway, PLLC accept Medicare?
- Russell Dermatology of Conway, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Russell Dermatology of Conway, PLLC?
- The authorized official listed on Russell Dermatology of Conway, PLLC's NPPES record is Jackie Russell, Bus/Office Mgr. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Russell Dermatology of Conway, PLLC's NPI active?
- Yes — Russell Dermatology of Conway, PLLC's NPI (1639134067) is active in the NPPES registry as of the last update on 2025-10-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.