Individual
DR. AARON JACOB RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
969 N MASON RD, DIV IM DERMATOLOGY, STE 220, SAINT LOUIS, MO 63141-6282
(314) 273-3376
(888) 682-0525
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 273-3376
(888) 682-0525
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2021011092
MO
207ZD0900X
Dermatopathology (Pathology) Physician
2021011092
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200061535
—
MO
Enumeration date
06/28/2016
Last updated
04/17/2025
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