Deidre J. Russell, M.D.,LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

00019979 Issued in AL

Legal business name

DEIDRE J. RUSSELL, M.D.,LLC

Practice address

203 Vaughan Memorial Dr
Selma, AL 36701-6950

Phone

(334) 875-2134

Fax

(334) 875-4331

NPI assigned

May 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Deidre Russell, MDNPI 1467565341

Title

Physician

Phone

(334) 875-2134

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deidre Russell, M.D.

  • Obstetrics & Gynecology Physician
  • Maricopa, AZ
  • NPI 1467565341

  Specialist

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003863846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1470",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367021470",
            "telephone_number": "334-875-2134",
            "fax_number": "334-875-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 VAUGHAN MEMORIAL DR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016950",
            "telephone_number": "334-875-2134",
            "fax_number": "334-875-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEIDRE J. RUSSELL, M.D.,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DEIDRE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "334-875-2134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "00019979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09475",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Subramonium K Das, M.D.
• David W. Hodo, M.D., P.a.
• Davis Family Medicine
• Glenton W Davis, M.D.
• Olivia Grayson Davis, FNP
• Mezzy Anne Bernardino Dela Pierre, RN, BSN
• Glenn Ray Delp, M.D.
• Holland Dempsey
• Diabetic Shoppe Inc
• Diversicare of Selma, LLC

• Specialist in Selma, AL
• Providers in Selma, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.