Individual
DR. RUSSELL PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
K0364
TX
2085R0202X
Diagnostic Radiology Physician
Primary
K0364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141288403
—
TX
05
—
141288404
—
TX
01
—
141288406
CSHCN1
TX
01
—
141288408
CSHCN2
TX
01
—
300133592
RRMCARE2
—
01
—
300133594
RRMCARE
—
Enumeration date
06/10/2005
Last updated
04/05/2021
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