| Keith Perry Russell, MD | |
|
200 State Highway 30 W, New Albany, MS 38652-3112 | |
| (800) 889-8610 | |
| (601) 982-7909 |
| Full Name | Keith Perry Russell |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 14 Years |
| Location | 200 State Highway 30 W, New Albany, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326335886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | T-2483 (Mississippi) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 24818 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Clay County Medical Corporation | West point, MS | Hospital |
| North Mississippi Medical Center | Tupelo, MS | Hospital |
| Winston Medical Center & Swingbed | Louisville, MS | Hospital |
| Baptist Memorial Hospital - Calhoun, Inc. | Calhoun city, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boa Vida Hospital Of Aberdeen Ms Llc | 0244505840 | 61 |
| Oxford Pre Op And Imaging Center Llc | 0840444998 | 19 |
| Choctaw Regional Medical Center | 2567682206 | 32 |
| Premier Radiology Inc | 2769452242 | 26 |
| Baptist Memorial Hospital - Calhoun Inc | 5395024210 | 24 |
| Medical Imaging, Llc | 5698731271 | 18 |
| Imaging Center At Gloster Creek Village Pllc | 5991771255 | 20 |
| Tate County Hospital | 6103282165 | 28 |
| Imaging Centers For Excellence, Llc | 6406854538 | 15 |
| Winston County Medical Foundation | 7315943255 | 28 |
| Entity Name | Premier Radiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083669121 PECOS PAC ID: 2769452242 Enrollment ID: O20040730000681 |
| Entity Name | Imaging Center At Gloster Creek Village Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417907536 PECOS PAC ID: 5991771255 Enrollment ID: O20040908000606 |
| Entity Name | Medical Imaging, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316075864 PECOS PAC ID: 5698731271 Enrollment ID: O20041206000515 |
| Entity Name | Tippah County Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891720009 PECOS PAC ID: 5193746709 Enrollment ID: O20051212000167 |
| Entity Name | Winston County Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316078108 PECOS PAC ID: 7315943255 Enrollment ID: O20061017000019 |
| Entity Name | Imaging Centers For Excellence, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730281148 PECOS PAC ID: 6406854538 Enrollment ID: O20061127000362 |
| Entity Name | Oxford Pre Op & Imaging Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750646436 PECOS PAC ID: 0840444998 Enrollment ID: O20130125000383 |
| Entity Name | Radiology Physicians Of New Albany Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861822587 PECOS PAC ID: 9638302300 Enrollment ID: O20140502001561 |
| Entity Name | Choctaw Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235547878 PECOS PAC ID: 2567682206 Enrollment ID: O20141215002502 |
| Entity Name | Baptist Memorial Hospital - Calhoun Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881142461 PECOS PAC ID: 5395024210 Enrollment ID: O20161203000022 |
| Entity Name | Boa Vida Hospital Of Aberdeen Ms Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710405741 PECOS PAC ID: 0244505840 Enrollment ID: O20171128003460 |
| Entity Name | Tate County Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285331298 PECOS PAC ID: 6103282165 Enrollment ID: O20230517000566 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Perry Russell, MD Po Box 4767, Jackson, MS 39296-4767 Ph: (800) 889-8610 | Keith Perry Russell, MD 200 State Highway 30 W, New Albany, MS 38652-3112 Ph: (800) 889-8610 |