Individual
DR. JACOB RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
6255 E GRANT RD, TUCSON, AZ 85712-5804
(520) 298-7094
(520) 886-9816
Mailing address
6255 E GRANT RD, TUCSON, AZ 85712-5804
(520) 298-7094
(520) 886-9816
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S015590
AZ
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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