Individual
KENNETH J RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9097 E DESERT COVE DR STE 260, SCOTTSDALE, AZ 85260-6278
(480) 684-1080
Mailing address
9097 E DESERT COVE # 260, SCOTTSDALE, AZ 85260
(480) 684-1080
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
12608
AZ
Other
Enumeration date
01/24/2006
Last updated
12/04/2012
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