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Search › Arizona › 152W00000X

Kevin Russell, O.D

NPI 1194905257 · on the registry since 2007 · sole proprietor

Practice

Address
2048 E. Baseline Rd.
Suite C6
Mesa, AZ 85204
Phone
(480) 245-8929
Fax
(480) 507-0836
Organisation at this address
Eyes On Mesa, Pllc
Licata Optical Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
152W00000X
152W00000X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-04-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona