Individual
DR. STEPHEN A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 E BLOUNT AVE, SUITE 507, KNOXVILLE, TN 37920-1614
(865) 525-9414
(865) 525-9452
Mailing address
PO BOX 343, KNOXVILLE, TN 37901-0343
(865) 525-9414
(865) 525-9452
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11675
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3187566
—
TN
Enumeration date
12/18/2006
Last updated
02/19/2018
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