Individual
DR. STEPHEN RUSSELL DEPUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 POYDRAS ST, SUITE 1640, NEW ORLEANS, LA 70112-1221
(504) 412-1835
Mailing address
1340 POYDRAS ST, SUITE 1640, NEW ORLEANS, LA 70112-1221
(504) 412-1835
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
12224R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118537
—
MS
05
—
1698300
—
LA
Enumeration date
06/29/2006
Last updated
02/06/2012
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