Individual
DR. THOMAS GERALD RUSSELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1099 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1159
(270) 251-4242
(270) 251-4240
Mailing address
934 STATE ROUTE 2205, MAYFIELD, KY 42066-4886
(270) 247-9601
(270) 247-9601
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27843
KY
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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