Individual
FRANK DAVID RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-3807
(228) 376-0105
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-3807
(228) 376-0105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26240
MS
207RC0000X
Cardiovascular Disease Physician
26240
MS
207RC0000X
Cardiovascular Disease Physician
MD.31539
AL
207RI0011X
Interventional Cardiology Physician
Primary
26240
MS
Other
Enumeration date
01/25/2010
Last updated
05/24/2022
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