Individual
ROBERT THOMASON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
31614
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02875872
—
MS
05
—
140016
—
AL
05
—
140183
—
AL
Enumeration date
01/04/2007
Last updated
09/12/2012
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