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Individual

JEREMY W RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3901 STEWART AVE, WAUSAU, WI 54401-3948
(715) 907-0900
(715) 803-6977
Mailing address
3901 STEWART AVE, WAUSAU, WI 54401-3948
(715) 907-0900
(715) 803-6977

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
55775
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100016494
WI
Enumeration date
05/08/2007
Last updated
02/18/2026
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