Organization
SAMUEL J RUSSO DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL J RUSSO DO (OWNER)
(541) 677-6586
Entity
Organization
Contact information
Practice address
2460 NW STEWART PKWY, SUITE 100, ROSEBURG, OR 97471-1516
(541) 677-6586
(541) 677-6509
Mailing address
2460 NW STEWART PKWY, SUITE 100, ROSEBURG, OR 97471-1516
(541) 677-6586
(541) 677-6509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/25/2006
Last updated
08/27/2008
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