Richard R Russell, PA

NPI #1184647786 in Roy, Utah

Provider Information

NPI Number: 1184647786
Entity Type: Individual
Name: Richard R Russell, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jul 25, 2006
Last Updated: Jul 9, 2008

Practice Location

Address: 1915 W 5950 S
City: Roy
State: Utah
ZIP Code: 84067-1454
Phone: (801) 387-8100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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