Individual
RUSSELL H TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 MEDICAL DR STE 150, BOUNTIFUL, UT 84010-5085
(801) 298-3247
(801) 298-9675
Mailing address
PO BOX 405831, ATLANTA, GA 30384-5831
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
95 293774 1205
UT
Other
Enumeration date
10/17/2005
Last updated
11/30/2020
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