Jacob Robert Russell, DO

NPI #1417318361 in Surprise, Arizona

Provider Information

NPI Number: 1417318361
Entity Type: Individual
Name: Jacob Robert Russell, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Emergency Medicine
Credential: DO
Enumeration Date: Mar 18, 2016
Last Updated: Jul 8, 2022

Practice Location

Address: 16815 W BELL RD
City: Surprise
State: Arizona
ZIP Code: 85374-2101
Phone: (602) 833-6900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine - Emergency Medical Services — Emergency Medical Services	207PE0004X
Student in an Organized Health Care Education/Training Program	390200000X
Emergency Medicine	207P00000X	Primary

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