Individual
MR. BARRY D. RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1450 MORRELL AVE, CONNELLSVILLE, PA 15425-3809
(724) 626-4486
Mailing address
11 LINDSAY DR, UNIONTOWN, PA 15401-9430
(724) 439-1636
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OEG000421
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1565357
—
PA
Enumeration date
04/23/2007
Last updated
06/16/2011
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