Individual
DR. RUSSELL LEE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78270 HIGHWAY 1081, COVINGTON, LA 70435-4646
(985) 867-5680
Mailing address
78270 HIGHWAY 1081, COVINGTON, LA 70435-4646
(985) 867-5680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R042107
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1696684
—
LA
Enumeration date
01/26/2007
Last updated
07/08/2007
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