Individual
DR. RUSSELL DEAN ULRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
25 ROUNDTREE DR, PIEDMONT, AL 36272-5893
(256) 447-9045
(256) 447-9040
Mailing address
25 ROUNDTREE DR, PIEDMONT, AL 36272-5893
(256) 447-9045
(256) 447-9040
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
DO 47
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000010742
—
AL
01
—
510-10742
BLUE CROSS
AL
Enumeration date
06/09/2005
Last updated
01/28/2021
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