Individual
DR. RICHARD JOHN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-2366
(319) 356-2940
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-2366
(319) 356-2940
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2152
WI
207L00000X
Anesthesiology Physician
DR.0051868
CO
207L00000X
Anesthesiology Physician
Primary
MD-51255
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005673
WELLMARK NUMBER
SD
01
—
050059966
RAILROAD MEDICARE
SD
05
—
113538400
—
WY
05
—
5700780
—
SD
05
—
79550762
—
CO
01
—
P01223541
RR MEDICARE
CO
Enumeration date
01/12/2006
Last updated
05/31/2023
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