Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
DR. KENNETH L RUSSELL
Active
Individual
DR. KENNETH L RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H6568
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
H6568
TX
207RG0100X
Gastroenterology Physician
H6568
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
H6568
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140407162
—
TX
01
—
86618G
BCBSTX
TX
01
—
H6568
STATE MEDICAL LICENSE
TX
Enumeration date
09/27/2006
Last updated
11/15/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up