Organization
ADULT MEDICINE SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS A RUSSELL M.D. (PRESIDENT)
(402) 991-0137
Entity
Organization
Contact information
Practice address
10020 NICHOLAS ST STE 202, OMAHA, NE 68114-2188
(402) 991-0137
(402) 991-0236
Mailing address
10020 NICHOLAS ST STE 202, OMAHA, NE 68114-2188
(402) 991-0137
(402) 991-0236
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025045800
—
NE
Enumeration date
11/17/2006
Last updated
08/16/2013
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