Individual
RUSSELL LEE BEDSOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 WESTSIDE DR, DOTHAN, AL 36303-1928
(334) 793-5074
(334) 793-6460
Mailing address
210 WESTSIDE DR, DOTHAN, AL 36303-1928
(334) 793-5074
(334) 793-6460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29594
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111927
—
AL
05
—
200514770
—
IN
05
—
2528438
—
OH
01
—
29594
ALABAMA MEDICAL LICENSURE COMMISSION
AL
05
—
64098262
—
KY
Enumeration date
04/19/2006
Last updated
03/03/2021
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