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Jason Russell
Driver in Southaven, Mississippi
NPI 1225717325

Jason Russell is a Driver based in Memphis, MS. Jason Russell practices in Southaven, MS. The NPI Number for Jason Russell is 1225717325 and holds a License No. 086149826 (Mississippi).

The current practice location address for Jason Russell is 8331 Blue Ridge Dr, Southaven, MS and can be reached out via phone at 901-857-5961. You can also correspond with Jason Russell through the mailing address at 5425 LAKE VILLAGE DR, MEMPHIS, TN - 38125-4106 (mailing address contact number: 901-292-1308).

Location: 8331 Blue Ridge Dr, Southaven, MS, 38125-4106
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225717325
Provider Name
Jason Russell
Credential
Provider Entity Type
Individual
Gender
Male
Address
8331 Blue Ridge Dr, Southaven, MS, 38125-4106
Phone Number
901-857-5961
Fax Number
Provider Enumeration Date
07/14/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
8331 Blue Ridge Dr
City
Southaven
State
Mississippi
Zip
38672-6589
Phone Number
901-857-5961
Fax Number
person
Provider Business Mailing Address Details
Address
8331 Blue Ridge Dr
City
Southaven
State
Mississippi
Zip
38672-6589
Phone Number
901-857-5961
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
172A00000X
License No.
086149826 (Tennessee)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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