DR. Justin William Russell

NPI #1114630456 in Loudon, Tennessee

Provider Information

NPI Number: 1114630456
Entity Type: Individual
Name: DR. Justin William Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Jan 2, 2023
Last Updated: Jan 5, 2023

Practice Location

Address: 2111 HIGHWAY 72 N
City: Loudon
State: Tennessee
ZIP Code: 37774-5719
Phone: (865) 458-9938

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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