Individual
FREDERICK RUSSEK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3458 E LOWELL AVE, GILBERT, AZ 85295-1554
(702) 556-2260
Mailing address
3458 E LOWELL AVE, GILBERT, AZ 85295-1554
(702) 556-2260
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2202
AZ
208D00000X
General Practice Physician
2202
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002002781
—
NV
05
—
256661
—
AZ
Enumeration date
12/21/2005
Last updated
12/16/2025
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