Individual
DR. DALLAS M RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
790 MONTCLAIR RD, STE 210, BIRMINGHAM, AL 35213-1966
(205) 595-3600
(205) 595-3663
Mailing address
790 MONTCLAIR RD, STE 210, BIRMINGHAM, AL 35213-1966
(205) 595-3600
(205) 595-3663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12098
AL
2084N0400X
Neurology Physician
12098
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5290002380
—
AL
Enumeration date
05/27/2005
Last updated
03/20/2008
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