Russell Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

208D00000X Issued in MS

Legal business name

RUSSELL MEDICAL CLINIC

Practice address

402 Doctors Dr
New Albany, MS 38652-3109

Phone

(662) 534-2486

Fax

(662) 534-2839

NPI assigned

Oct 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard H. Russell, M.D.

Title

Owner/Physician

Phone

(662) 534-2486

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1205024452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 DOCTORS DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523109",
            "telephone_number": "662-534-2486",
            "fax_number": "662-534-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DOCTORS DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523109",
            "telephone_number": "662-534-2486",
            "fax_number": "662-534-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "662-534-2486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "208D00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C02872",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015413",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rowan Family Dentistry, Inc.
• David Kevin Rowan, DMD
• Deborah Michelle Rowan, RN
• Marley Rumbarger, FNP
• Kara Rushing, FNP-C
• Keith Perry Russell, M.D.
• Sandra Allison Russell, NP-C
• Sageberry Psychology, LLC
• Shelia A Sancillo Tice, CFNP
• Tony D Sanford Sr.

• Family Medicine Physician in New Albany, MS
• Providers in New Albany, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.