Individual
DR. RICKY GORDON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 MARSHALL ST, SUITE 603, JACKSON, MS 39202-1651
(601) 985-9120
(601) 985-9122
Mailing address
501 MARSHALL ST, SUITE 603, JACKSON, MS 39202-1651
(601) 985-9120
(601) 985-9122
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9309
MS
Other
Enumeration date
08/18/2006
Last updated
01/29/2014
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