Individual
DR. DAVID PAUL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
249 MIDWAY MEDICAL PARK, BRISTOL, TN 37620-1693
(423) 968-3033
(423) 968-3789
Mailing address
249 MIDWAY MEDICAL PARK, BRISTOL, TN 37620-1693
(423) 968-3033
(423) 968-3789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19081
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006241069
—
VA
Enumeration date
05/08/2006
Last updated
06/23/2020
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