Individual
DR. KYLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
129 T.T. LANIER ST, LILLINGTON, NC 27546
(910) 893-1560
Mailing address
129 T.T. LANIER ST, LILLINGTON, NC 27546
(910) 893-1560
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2021-02106
NC
Other
Enumeration date
07/10/2018
Last updated
07/07/2022
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