Doctor Name: | DR. RICHARD HAROLD RUSSELL |
NPI Number: | 1689696759 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 06238 |
Business Practice Address: | 1013 County Road 362 S New Albany, MS - 386528855 |
Business Phone Number: | 6625348979 |
Business Fax Number: | 6624888729 |
Mailing Address: | 1013 County Road 362 S, NEW ALBANY |
State: | MS |
Postal Code: | 386528855 |
Phone Number: | 6625348979 |
Fax Number: | 6624888729 |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 06/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 06238 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |