Individual
DR. ROBERT C. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
431 HOMER RD, MINDEN, LA 71055-2933
(318) 377-8855
(318) 371-1170
Mailing address
431 HOMER RD, MINDEN, LA 71055-2933
(318) 377-8855
(318) 371-1170
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
020174
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932132
—
LA
Enumeration date
06/26/2006
Last updated
06/16/2011
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