Individual
JANET YOUNG RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4939 W RAY RD, SUITE 28, CHANDLER, AZ 85226-2065
(480) 785-8800
Mailing address
12014 E WELSH TRL, SCOTTSDALE, AZ 85259-5108
(480) 451-8150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25180
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25180
ARIZONA STATE MEDICAL LICENSE
AZ
Enumeration date
08/27/2008
Last updated
08/27/2008
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