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Individual

JAMES CRAIG RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 W THOMAS RD, STE 400, PHOENIX, AZ 85013-4222
(602) 406-3874
(602) 406-4011
Mailing address
FILE 56765, LOS ANGELES, CA 90074-6765
(602) 406-3860
(602) 406-6132

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
21323
AZ
2086S0127X
Trauma Surgery Physician
Primary
21323
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142042
AZ
Enumeration date
06/14/2005
Last updated
05/15/2012
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