Individual
DR. RICHARD WILLIAM RUSSILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1550 BOYSON RD, HIAWATHA, IA 52233-2362
(319) 743-7300
(319) 743-7311
Mailing address
1550 BOYSON RD, HIAWATHA, IA 52233-2362
(319) 743-7300
(319) 743-7311
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD-47149
IA
207LA0401X
Addiction Medicine (Anesthesiology) Physician
R-10612
IA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
R-10612
IA
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
R-10612
IA
207LP2900X
Pain Medicine (Anesthesiology) Physician
R-10612
IA
207LP3000X
Pediatric Anesthesiology Physician
R-10612
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD-47149
MEDICAL LICENSE
IA
Enumeration date
06/17/2016
Last updated
04/18/2025
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