Duane L. Russell, M.D.

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

017375 Issued in MS

Practice address

117 S 11TH Ave
Laurel, MS 39440-4312

Phone

(601) 425-3033

Fax

(601) 428-6561

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1962408658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 11TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404312",
            "telephone_number": "601-425-3033",
            "fax_number": "601-428-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 11TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404312",
            "telephone_number": "601-425-3033",
            "fax_number": "601-428-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DUANE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MS",
            "license": "017375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124892",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roslyn Ashford Wellness, Inc.
• Thomas S. Rowland Jr., D.M.D.
• Teresa Ruffin, IDD WAIVER SERVICES
• Kayla Rushing, FNP-C
• Ann M Rushton, CMHT
• Ginny Breann Russell
• Onkar Sallan, DO
• Marion Stacie Sammons, NP-C
• Jack Larry Sanders, R PH
• Marsha Myrick Sanders, R.PH.

• Legal Medicine in Laurel, MS
• Providers in Laurel, MS by specialty
• Legal Medicine in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.