Individual
ANDREW RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 636-0200
(479) 986-3448
Mailing address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 636-0200
(479) 986-3448
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2022015511
MO
207R00000X
Internal Medicine Physician
Primary
E-13608
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2019
Last updated
07/14/2023
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