Organization
RUSSELL W. ROBERTSON, M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL WRIGHT ROBERTSON M.D. (OWNER)
(860) 246-1203
Entity
Organization
Contact information
Practice address
85 SEYMOUR ST, SUITE 519, HARTFORD, CT 06106-5501
(860) 246-1203
(860) 246-1145
Mailing address
85 SEYMOUR ST, SUITE 519, HARTFORD, CT 06106-5501
(860) 246-1203
(860) 246-1145
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
16087
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010016087CT01
BLUE CROSS
CT
01
—
077233
CTC
CT
05
—
1160878
—
CT
Enumeration date
07/17/2008
Last updated
07/17/2008
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