Organization
RUSSELL J PROCTOR MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL J PROCTOR MD (OWNER)
(251) 974-1550
Entity
Organization
Contact information
Practice address
4223 ORANGE BEACH BLVD, STE. A, ORANGE BEACH, AL 36561-3459
(251) 981-8713
Mailing address
PO BOX 7627, MOBILE, AL 36670-0627
(251) 974-1550
(251) 974-1551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
10/25/2006
Last updated
06/21/2018
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