Individual
RUSSELL C BROCKWELL
Active
Individual
RUSSELL C BROCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME98102
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000007602
BLUE CROSS
AL
01
—
000007604
BLUE CROSS
AL
01
—
000007609
BLUE CROSS
AL
05
—
000007609
—
AL
05
—
009916165
—
AL
05
—
009916175
—
AL
01
—
010033CG86101
SECTION 1011
AL
01
—
050065291
RAILROAD MEDICARE
AL
01
—
06857292
MISSISSIPPI MEDICAID
MS
01
—
42512
HEALTHSPRING
AL
01
—
G86101
VIVA
AL
Enumeration date
06/07/2006
Last updated
12/21/2023
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