Individual
DR. RUSSELL EUGENE FOTHERGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1713 SW H K DODGEN LOOP STE 100, TEMPLE, TX 76502-1836
(254) 771-8100
(254) 771-8101
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L2890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659237-01
CSHCN
TX
05
—
1659237-01
—
TX
01
—
8P1481
BLUE SHIELD
TX
01
—
P00195392
RR/MEDICARE
TX
Enumeration date
03/27/2006
Last updated
12/08/2021
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