Individual
KELLY YVETTE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 N CENTRAL AVE, STE1600, PHOENIX, AZ 85004-4527
(602) 744-4765
(602) 744-4799
Mailing address
1850 N CENTRAL AVE, STE1600, PHOENIX, AZ 85004-4527
(602) 744-4765
(602) 744-4799
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
31084
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811861
—
AZ
Enumeration date
01/19/2006
Last updated
10/14/2010
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