Individual
DR. DUANE L. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
117 S 11TH AVE, LAUREL, MS 39440-4312
(601) 425-3033
(601) 428-6561
Mailing address
117 S 11TH AVE, LAUREL, MS 39440-4312
(601) 425-3033
(601) 428-6561
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
017375
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0124892
—
MS
Enumeration date
06/27/2005
Last updated
07/11/2007
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