Individual
DR. JEFFREY S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
327 W CHICAGO ST, COLDWATER, MI 49036-2805
(517) 278-8000
(517) 278-8007
Mailing address
327 W CHICAGO ST, COLDWATER, MI 49036-2805
(517) 278-8000
(517) 278-8007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101011799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C CJ8339
MEDICARE RR
MI
05
—
4836462
—
MI
Enumeration date
06/16/2006
Last updated
02/19/2013
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