Individual
DR. GREGORY CLINTON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
102 PROFESSIONAL PARK PVT DR, KINGSPORT, TN 37663-2287
(423) 245-2222
(423) 245-4822
Mailing address
102 PROFESSIONAL PARK PVT DR, KINGSPORT, TN 37663-2287
(423) 245-2222
(423) 245-4822
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1813
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3941713
—
TN
01
—
4076931
BLUE CROSS BLUE SHIELD OF
TN
Enumeration date
07/12/2006
Last updated
07/09/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us