Individual
DR. ERIC BRIAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2425 DAVE WARD DR, SUITE 202, CONWAY, AR 72034-8686
(501) 328-5050
Mailing address
2425 DAVE WARD DR, SUITE 202, CONWAY, AR 72034-8686
(501) 328-5050
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
E3133
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150036001
—
AR
Enumeration date
01/12/2006
Last updated
11/09/2010
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