Russell J Proctor MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RUSSELL J PROCTOR MD LLC

Practice address

4223 Orange Beach Blvd
Ste. a
Orange Beach, AL 36561-3459

Phone

(251) 981-8713

NPI assigned

Oct 25, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Russell J Proctor, MD

Title

Owner

Phone

(251) 974-1550

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1952485658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7627",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366700627",
            "telephone_number": "251-974-1550",
            "fax_number": "251-974-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4223 ORANGE BEACH BLVD",
            "address_2": "STE. A",
            "city": "ORANGE BEACH",
            "state": "AL",
            "postal_code": "365613459",
            "telephone_number": "251-981-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL J PROCTOR MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-974-1550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Orange Beach, AL
• Providers in Orange Beach, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.