Macy E Russell

NPI #1174285225 in Oakwood, Ohio

Provider Information

NPI Number: 1174285225
Entity Type: Individual
Name: Macy E Russell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Enumeration Date: Oct 6, 2021
Last Updated: Oct 6, 2021

Practice Location

Address: 414 OAKWOOD AVE
City: Oakwood
State: Ohio
ZIP Code: 45409-2217
Phone: (937) 548-3063

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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