NPI 1003863846

Deidre J. Russell, M.D.,llc

Organisation Specialist Selma, AL

Practice location

Address: 203 Vaughan Memorial Dr, Selma, AL 36701-6950
Phone: (334) 875-2134
Fax: (334) 875-4331
Mailing address: PO Box 1470, Selma, AL 36702-1470

Authorised official

Name: Deidre Russell
Title: Physician
Phone: (334) 875-2134

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 00019979 (AL)

Other Specialist providers in Alabama →

Registry record

NPI: 1003863846
Entity type: Organization
NPI issued: 27 May 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.