Individual
RUSSELL S WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 MEDICAL CENTER DRIVE, SUITE 201, GADSDEN, AL 35903
(256) 492-6982
(256) 494-1958
Mailing address
300 MEDICAL CENTER DRIVE, SUITE 201, GADSDEN, AL 35903
(256) 492-6982
(256) 494-1958
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
L9013
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD.9524
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101301
—
AL
01
—
51548442
BCBS OF AL
AL
Enumeration date
08/09/2005
Last updated
10/01/2009
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