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Individual

DR. RUSSELL PAUL LANDRY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
651 DUNLOP LANE, CLARKSVILLE, TN 37040
(713) 430-6095
Mailing address
1303 US HWY 127 S STE 402, BOX 367, FRANKFORT, KY 40601
(713) 430-6095

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
51961
KY
207P00000X
Emergency Medicine Physician
Primary
62086
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2414038
LA
Enumeration date
03/28/2016
Last updated
08/02/2023
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