Individual
EDMOND V RUSS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 HARRODSBURG RD STE 100, LEXINGTON, KY 40504-3601
(859) 278-7226
(859) 276-1540
Mailing address
1725 HARRODSBURG RD STE 100, LEXINGTON, KY 40504-3601
(859) 278-7226
(859) 276-1540
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35082471R
OH
2085R0202X
Diagnostic Radiology Physician
Primary
53439
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387297
—
OH
05
—
7100669920
—
KY
01
—
K300750
MEDICARE
KY
Enumeration date
02/08/2006
Last updated
02/05/2021
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