Individual
DR. RUSSELL JAN GEOFFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2411 MARTIN LUTHER KING JR BLVD, EUGENE, OR 97401-5824
(541) 682-7267
(541) 682-3707
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-7267
(541) 682-3707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD162575
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500658448
—
OR
Enumeration date
05/11/2007
Last updated
12/18/2013
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