Individual
DR. ANTHONY OTIS RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1633 PHYSICIANS DR, TALLAHASSEE, FL 32308-4620
(850) 431-3276
Mailing address
1633 PHYSICIANS DR, TALLAHASSEE, FL 32308-4620
(850) 431-3276
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
ME127853
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME127853
FL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
ME127853
FL
208VP0014X
Interventional Pain Medicine Physician
ME127853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018286400
—
FL
Enumeration date
08/11/2005
Last updated
09/15/2025
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