Individual
ROBERT CODY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1118 ROSS CLARK CIRCLE, SUITE 100, DOTHAN, AL 36301
(334) 794-1148
Mailing address
1118 ROSS CLARK CIRCLE, SUITE 100, DOTHAN, AL 36301
(334) 794-1148
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-130087
AL
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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