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Individual
RON C. RUSSELL
Active
Individual
RON C. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11080
MS
208M00000X
Hospitalist Physician
Primary
11080
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119498
—
MS
05
—
009811080
—
AL
01
—
110167818
RAILROAD MEDICARE
—
01
—
731-02318
BLUE CROSS OF AL
—
Enumeration date
11/17/2005
Last updated
11/09/2013
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