Individual
KIM L RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2525 CUMBERLAND PKWY SE, DEPARTMENT OF DERMATOLOGY, ATLANTA, GA 30339-3915
(770) 431-4330
(770) 431-4193
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
002298
GA
Other
Enumeration date
12/01/2006
Last updated
01/06/2022
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