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Individual
DR. RICHARD RAWLS RUSSELL
Active
Individual
DR. RICHARD RAWLS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
872-292T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1308021
—
LA
01
—
2267B
BLUE CROSS BLUE SHIELD OF LOUISIANA
—
01
—
30048
UNITED COMMERCIAL TRAVELORS OF AMERICA
—
01
—
72128
VANTAGE HEALTH PLAN
—
01
—
98171
ARKANSAS BLUE CROSS BLUE SHIELD
—
Enumeration date
11/29/2006
Last updated
12/29/2008
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