Organization
RUSSELLVILLE PHYSICIAN PRACTICES LLC
Active
Other names
Russellville General Surgey
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MANGUM (SR DIRECTOR)
(615) 565-1898
Entity
Organization
Contact information
Practice address
15225 HIGHWAY 43, SUITE I, RUSSELLVILLE, AL 35653-1999
(256) 332-1533
Mailing address
PO BOX 1216, RUSSELLVILLE, AL 35653-1216
(256) 332-1533
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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