Individual
DAVID JOSEPH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 BRYANT WILLIAMS DR, KLAMATH FALLS, OR 97601-1120
(541) 274-2894
(541) 274-3392
Mailing address
PO BOX 5109, KLAMATH FALLS, OR 97601-0119
(541) 882-1540
(541) 882-2583
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A89958
CA
208600000X
Surgery Physician
Primary
MD28531
OR
2086S0129X
Vascular Surgery Physician
MD28531
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024213
—
OR
Enumeration date
07/15/2008
Last updated
07/08/2022
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