SearchArkansas332B00000X

Richard Russell

NPI 1326196593 · on the registry since 2007 · sole proprietor

Practice

Address
3165 Boone Dr
Conway, AR 72034
Phone
(501) 504-2126
Fax
(501) 504-2126

Registry record

Primary taxonomy
332B00000X
332B00000X
Licence states on file
AR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-07-09

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 Arkansas