DR. Kevin Joseph Russell, O.D.

NPI #1194905257 in Mesa, Arizona

Provider Information

NPI Number: 1194905257
Entity Type: Individual
Name: DR. Kevin Joseph Russell, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Nov 6, 2007
Last Updated: Apr 24, 2018

Practice Location

Address: 2048 E. BASELINE RD.
Address 2: SUITE C6
City: Mesa
State: Arizona
ZIP Code: 85204
Phone: (480) 245-8929

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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