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Jerrold Russell, OD
NPI 1679526990 · on the registry since 2006
Practice
- Address
- 1341 Park Ave
Columbus, WI 53925 - Phone
- (920) 623-2431
- Fax
- (920) 623-3656
Registry record
- Primary taxonomy
- Optometrist
152W00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-01-22
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 Wisconsin