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Individual

MR. JEFFREY WYAN RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MHS, PA-C

Contact information

Practice address
2741 DEBARR RD, SUITE C-308, ANCHORAGE, AK 99508-2953
(907) 272-3366
(907) 272-0269
Mailing address
PO BOX 140386, ANCHORAGE, AK 99514-0386
(907) 277-0972

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
371
AK

Other

Enumeration date
04/05/2007
Last updated
07/08/2007
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