Individual
DR. LAWRENCE I RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4212 WEST CONGRESS STREET, SUITE 1401, LAFAYETTE, LA 70506
(337) 981-8131
(337) 989-1316
Mailing address
4212 WEST CONGRESS STREET, SUITE 1401, LAFAYETTE, LA 70506
(337) 981-8131
(337) 989-1316
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
014024
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1167169
—
LA
Enumeration date
07/07/2005
Last updated
03/25/2010
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