Individual
WILL THOMAS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
206 E BROWN ST, EAST STROUDSBURG, PA 18301-3094
(570) 476-3353
Mailing address
2545 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-7300
(484) 884-2888
(484) 884-2885
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS015414
PA
207P00000X
Emergency Medicine Physician
OT012329
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0483923
—
NJ
Enumeration date
06/27/2008
Last updated
12/17/2024
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