Individual
DAVID P RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 PLEASANT VALLEY RD, SUITE 302, OWENSBORO, KY 42303-9774
(270) 417-7880
(270) 417-7888
Mailing address
1301 PLEASANT VALLEY RD, SUITE 302, OWENSBORO, KY 42303-9774
(270) 417-7880
(270) 417-7888
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20218
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197830
BCBS
—
01
—
340001298
RAILROAD MEDICARE
—
05
—
64-202187
—
KY
Enumeration date
07/01/2005
Last updated
06/10/2016
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