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Organization

RICKY RUSSELL, M.D. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICKY GORDON RUSSELL M.D. (PHYSICIAN)
(601) 985-9120
Entity
Organization

Contact information

Practice address
501 MARSHALL ST, SUITE 603, JACKSON, MS 39202-1651
(601) 985-9120
(601) 985-9122
Mailing address
501 MARSHALL ST, SUITE 603, JACKSON, MS 39202-1651
(601) 985-9120
(601) 985-9122

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Enumeration date
02/13/2007
Last updated
01/29/2014
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