Individual
VINCENT JOSEPH RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8405 N PIMA CENTER PKWY STE 101, SCOTTSDALE, AZ 85258-4669
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
12496
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200949
—
AZ
01
—
3Z3902
HEALTHNET ID
—
Enumeration date
09/17/2006
Last updated
08/03/2022
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