Individual
DR. JOHN ANDREW RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2606 HOSPITAL BLVD, 5 WEST, CORPUS CHRISTI, TX 78405-1804
(361) 902-6762
Mailing address
2606 HOSPITAL BLVD, 5 WEST, CORPUS CHRISTI, TX 78405-1804
(361) 902-6762
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P4107
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2012
Last updated
10/24/2012
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