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Individual

DR. ELIZABETH JOYCE RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
820 ARBUTUS AVE, OCONTO, WI 54153-2004
(920) 835-1100
(920) 835-1099
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37344
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11014110
WI
01
1851477913
CMH NPI
WI
05
32194900
WI
01
537527
AMERICAN BOARD OF FAMILY MEDICINE
Enumeration date
08/08/2006
Last updated
09/22/2020
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