Individual
DR. RUSSELL C. PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4659 FM 1990, PALESTINE, TX 75801-1162
(903) 213-2216
(903) 213-9233
Mailing address
4000 S LOOP 256 STE A-E, PALESTINE, TX 75801-8467
(903) 731-5372
(903) 731-5130
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
ME30779
FL
2084P0800X
Psychiatry Physician
Primary
L5082
TX
2084P0800X
Psychiatry Physician
ME30779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881686392
NPI
FL
Enumeration date
08/19/2005
Last updated
06/08/2023
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