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Organization
LARRY J RUSSELL
Active
Organization
LARRY J RUSSELL
Active
Other names
Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA H WARD (PRACTICE MANAGER)
(828) 693-4431
Entity
Organization
Contact information
Practice address
510 BALSAM RD, HENDERSONVILLE, NC 28792-5703
(828) 693-4431
(828) 693-4871
Mailing address
510 BALSAM RD, HENDERSONVILLE, NC 28792-5703
(828) 693-4431
(828) 693-4871
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901249
—
NC
05
—
NPB019
—
SC
Enumeration date
02/14/2006
Last updated
08/22/2020
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