Individual
DEE B RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
304 SHORTER AVE NW, SUITE 201, ROME, GA 30165-4290
(706) 509-3300
(706) 509-4596
Mailing address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3224
(706) 509-3000
(706) 509-4608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
019593
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00182421A
—
GA
Enumeration date
07/24/2006
Last updated
05/15/2011
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