Individual
JON A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2021 N CAROTHERS RD, FRANKLIN, TN 37067-5822
(615) 791-2682
Mailing address
PO BOX 680189, FRANKLIN, TN 37068-0189
(877) 346-2211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3896824
—
TN
01
—
4092453
BCBS PROVIDER
—
01
—
P00131238
RAILROAD MEDICARE
—
Enumeration date
01/27/2006
Last updated
03/26/2021
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