Individual
RUSSELL DURING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2412 N OAK ST, VALDOSTA, GA 31602-2567
(229) 244-1400
(229) 244-5512
Mailing address
2412 N OAK ST, VALDOSTA, GA 31602-2567
(229) 244-1400
(229) 244-5512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005611
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005611
STATE LICENSE NUMBER
GA
Enumeration date
08/12/2009
Last updated
08/04/2026
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