Individual
DR. TIFFANY E RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1510 N STOCKTON HILL RD, KINGMAN, AZ 86401-5173
(928) 753-1177
Mailing address
PO BOX 1231, TUCSON, AZ 85702-1231
(520) 670-3909
(520) 309-2560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
332359
AZ
207R00000X
Internal Medicine Physician
DR0052648
CO
208000000X
Pediatrics Physician
DR0052648
CO
Other
Enumeration date
06/03/2009
Last updated
04/17/2026
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