Organization
RUSSELL MEDICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RANDALL RUSSELL M.D. (CHIEF EXECUTIVE OFFICER)
(870) 515-1289
Entity
Organization
Contact information
Practice address
5071 HIGHWAY 82 E, LAKE VILLAGE, AR 71653
(870) 515-1289
Mailing address
5071 HIGHWAY 82 E, LAKE VILLAGE, AR 71653
(870) 515-1289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4971
AS
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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