Individual
JACOB ROBERT RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
16815 W BELL RD, SURPRISE, AZ 85374-2101
(602) 833-6900
Mailing address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 265-8220
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
008645
AZ
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
3749
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2016
Last updated
07/08/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us