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Individual
DR. KERMIT RUSSELL RUST III
Active
Individual
DR. KERMIT RUSSELL RUST III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125058810
IL
2085R0202X
Diagnostic Radiology Physician
28347
OK
2085R0204X
Vascular & Interventional Radiology Physician
Primary
04-38788
KS
2085R0204X
Vascular & Interventional Radiology Physician
MD043000
DC
Other
Enumeration date
06/30/2010
Last updated
06/02/2021
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