NPI 1154681633

Daric J Russell, DO

Practitioner Pain Medicine (Anesthesiology) Physician Idaho Falls, ID

Practice location

Address: 3385 Potomac Way, Idaho Falls, ID 83404-4978
Phone: (208) 522-7246
Fax: (208) 529-2620

Registered specialties

Pain Medicine (Anesthesiology) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207LP2900X Licence 0-1036 (ID)

Other Anesthesiology providers in Idaho →

Registry record

NPI: 1154681633
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 May 2012
Record last updated: 6 Jan 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.