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Deidre J. Russell, M.d.,llc
Specialist in Selma, Alabama
NPI 1003863846

Deidre J. Russell, M.d.,llc is a Specialist based in Selma, AL. Deidre J. Russell, M.d.,llc practices in Selma, AL. The NPI Number for Deidre J. Russell, M.d.,llc is 1003863846 and holds a License No. 00019979 (Alabama).

The current practice location address for Deidre J. Russell, M.d.,llc is 203 Vaughan Memorial Dr, Selma, AL and can be reached out via phone at 334-875-2134 and via fax at 334-875-4331. You can also correspond with Deidre J. Russell, M.d.,llc through the mailing address at PO BOX 1470, SELMA, AL - 36702-1470 (mailing address contact number: 334-875-2134).

Location: 203 Vaughan Memorial Dr, Selma, AL, 36702-1470
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1003863846
Provider Name
Deidre J. Russell, M.d.,llc
Credential
Provider Entity Type
Organization
Address
203 Vaughan Memorial Dr, Selma, AL, 36702-1470
Phone Number
334-875-2134
Fax Number
334-875-4331
Provider Enumeration Date
05/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
09475 01 AL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
203 Vaughan Memorial Dr
City
Selma
State
Alabama
Zip
36701-6950
Phone Number
334-875-2134
Fax Number
334-875-4331
person
Provider Business Mailing Address Details
Address
203 Vaughan Memorial Dr
City
Selma
State
Alabama
Zip
36701-6950
Phone Number
334-875-2134
Fax Number
334-875-4331
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
00019979 (Alabama)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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