Individual
DR. JAMES RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2478 BURNSED BLVD # 466-A, THE VILLAGES, FL 32163-2702
(352) 399-5412
Mailing address
1774 WINDSORBROOKE DR, MARIETTA, GA 30062-4831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4461
FL
152W00000X
Optometrist
OPT2551
GA
Other
Enumeration date
09/10/2009
Last updated
04/21/2017
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