Individual
ROBERT THOMASON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 7TH AVE S # ACC300, BIRMINGHAM, AL 35233-1711
(205) 638-9688
Mailing address
1600 7TH AVE S # ACC300, BIRMINGHAM, AL 35233-1711
(205) 638-9688
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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