NPI 1558759480

Kevin D Russell

Practitioner Driver Columbia, MS

Practice location

Address: 1351 Gates Rd, Columbia, MS 39429-8948
Phone: (601) 441-2515
Fax: (601) 736-3872

Registered specialties (2)

Driver Primary

Other Service Providers Taxonomy 172A00000X

Other Driver providers in Mississippi →

Driver

Other Service Providers Taxonomy 172A00000X Licence 8878 (MS)

Registry record

NPI: 1558759480
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Dec 2014
Record last updated: 30 Dec 2014

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.