Individual
DR. RUSSELL J BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 EASTPOINT PKWY, SUITE 550, LOUISVILLE, KY 40223-4154
(502) 253-6630
(502) 253-6639
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5733
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36458
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000316211
ANTHEM
KY
05
—
64028491
—
KY
Enumeration date
07/21/2006
Last updated
12/10/2020
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