Individual
CAITLYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
575 FURYS FERRY RD, MARTINEZ, GA 30907-9059
(706) 691-7079
(706) 364-0416
Mailing address
575 FURYS FERRY RD, MARTINEZ, GA 30907-9059
(706) 922-6179
(706) 364-0416
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9732
GA
Other
Enumeration date
01/27/2020
Last updated
03/10/2025
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