| Russell Medical Clinic | |
|
402 Doctors Dr New Albany MS 38652-3109 | |
| (662) 534-2486 | |
| (662) 534-2839 |
| Full Name | Russell Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 402 Doctors Dr, New Albany, Mississippi |
| Authorized Official Name and Position | Richard H. Russell (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6625342486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Medical Clinic 402 Doctors Dr New Albany MS 38652-3109 Ph: (662) 534-2486 | Russell Medical Clinic 402 Doctors Dr New Albany MS 38652-3109 Ph: (662) 534-2486 |
| NPI Number | 1205024452 |
|---|---|
| Provider Enumeration Date | 10/11/2007 |
| Last Update Date | 10/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205024452 | NPI | - | NPPES |
| C02872 | Other | MS | MEDICARE GROUP |
| 09015413 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 208D00000X (Mississippi) | Primary |
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